Screening for Hyperparathyroidism by Measurement of Calcium in Patients Undergoing Thyroid Surgery: A Prospective Study

P. W. Rosário; G. F. Mourão; M. R. Calsolari

doi:10.1055/s-0042-115645

Hormone and Metabolic Research, Inhaltsverzeichnis

Horm Metab Res 2016; 48(10): 673-676
DOI: 10.1055/s-0042-115645

Endocrine Care

Screening for Hyperparathyroidism by Measurement of Calcium in Patients Undergoing Thyroid Surgery: A Prospective Study

Authors

P. W. Rosário

¹Postgraduate Program, Santa Casa de Belo Horizonte, Minas Gerais, Brazil and Endocrinology Service, Santa Casa de Belo Horizonte, Minas Gerais, Brazil
G. F. Mourão

¹Postgraduate Program, Santa Casa de Belo Horizonte, Minas Gerais, Brazil and Endocrinology Service, Santa Casa de Belo Horizonte, Minas Gerais, Brazil
M. R. Calsolari

¹Postgraduate Program, Santa Casa de Belo Horizonte, Minas Gerais, Brazil and Endocrinology Service, Santa Casa de Belo Horizonte, Minas Gerais, Brazil

Abstract

This study screened for asymptomatic primary hyperparathyroidism (PHPT) by measuring calcium (Ca) before thyroid surgery. The study was prospective. A total of 676 patients without a suspicion of PHPT were studied. PHPT was defined as elevated Ca (in 2 measurements) in the presence of PTH>25 pg/ml and in the absence of hypocalciuria. PHPT was diagnosed in 5 patients (0.74%), all of them women. One of the 5 patients with PHPT had no indication for parathyroidectomy (PTx) according to current guidelines. Parathyroid adenoma was easily identified during perioperative assessment of thyroid surgery in 3 patients. In the other 2 patients (0.3%), localization of the adenoma required specific exploration, which was only performed because of the preoperative diagnosis of PHPT. Normalization of Ca and PTH was achieved in all 5 patients. In conclusion, in patients without a clinical or ultrasonographic suspicion of PHPT, approximately 300 individuals should be screened before thyroid surgery to avoid one reoperation (PTx) due to PHPT, which does not seem to be cost-effective.

Key words

calcium - primary hyperparathyroidism - thyroidectomy

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Referenzen

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