Download PDF
CC BY-NC-ND 4.0 · J Lab Physicians 2010; 2(01): 010-013
DOI: 10.4103/0974-2727.66700
Original Article

Delayed serum calcium biochemical response to successful parathyroidectomy in primary hyperparathyroidism

Yousof Alabdulkarim
Notre-Dame Hospital University of Montreal Chum Montreal, QC, Canada
,
Edgard Nassif
Notre-Dame Hospital University of Montreal Chum Montreal, QC, Canada
› Author Affiliations
Source of Support: Nil
› Further Information
Also available at
 PDF Download Permissions and Reprints

ABSTRACT

Background: Parathyroidectomy is considered the standard treatment for primary hyperparathyroidism, however, though the onset of biochemical response is variable and is different from one patient to the other.

Aim: To evaluate the onset of systemic response and the biochemical normalization of serum calcium levels to a successful surgery.

Patients and Methods: In a retrospective fashion, we collected clinical data from 303 patients admitted to our hospital between 2005 and 2008, with a diagnosis of primary hyperparathyroidism after sestamibi localization. The pathology reports, parathyroidectomy results, the preoperative and postoperative parathormone (PTH) and serum calcium levels were reviewed. Response of each patient to the surgery was studied and all the data were analyzed to determine how fast the serum calcium levels drop.

Results: The majority of patients (72.9%, 221/303) showed a decrease in their serum calcium levels to normal values within 48 h. While in 40 patients it took 72 hours and 42 patients (13.8%) had a delayed normalization for more than 72 h. The pathology in the PH group was predominantly of a single adenoma 80.9% vs.19.1 with hyperplasia with a P of 0.03. Preoperative parathyroid hormone PTH elevation was not significantly deferent between the two groups (PH and EN) with a mean of 7.9±5.36 vs. 7.41±14.5 pmol/L respectively with a P of 0.43.

Conclusion: The majority of patients with primary hyperparathyroidism (PHP) respond to parathyroidectomy in the form of normalization of their serum calcium levels and PTH within 48 h; however, a certain group of patients will need more than 3 days.

Keywords

Biochemical response - calcium - endocrine - hyperparathyroidism


Publication History

Article published online:
29 January 2020

© 2010.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • REFERENCES

  • 1 Adamek S, Libansky P, Tvrdon J, Pafko P, Broulík P. Personal experience with a bilateral approach in the surgical treatment of primary hyperparathyroidism: A group of 222 patients with surgery for primary hyperparathyroidism from 1994 to 2000. Rozhl Chir 2002;81:443-9.
  • 2 Allen M, Almeida I, Torrinha J. Surgical treatment of primary hyperparathyroidism with intraoperative iPTH determination. Acta Med Port 2008;21:49-54.
  • 3 Barth A, Dambacher MA, Burgi H, Maurer W. New aspects in the surgical treatment of hyperparathyroidism. Schweiz Med Wochenschr 1987;117:574-8.
  • 4 Dubost C, Charbonnier JY, Assens P. Surgical treatment of primary hyperparathyroidism in patients over 70 years of age. Presse Med 1984;13:1773-5.
  • 5 Brasso K, Karstrup S, Lundby CM, Kristensen LO, Holm HH. Surgical treatment of primary hyperparathyroidism. Dan Med Bull 1994;41:585-8.
  • 6 Brothers TE, Thompson NW. Surgical treatment of primary hyperparathyroidism in elderly patients. Acta Chir Scand 1987;153:175-8.
  • 7 Bonnichon P. Treatment of primary hyperparathyroidism at Cochin hospital (Paris): Changes in procedures during the last thirty years. Ann Endocrinol (Paris) 2008;69:169-73.
  • 8 Bergson EJ, Sznyter LA, Dubner S, Palestro CJ, Heller KS. Sestamibi scans and intraoperative parathyroid hormone measurement in the treatment of primary hyperparathyroidism. Arch Otolaryngol Head Neck Surg 2004;130:87-91.
  • 9 Ferrer Baixauli F, Munoz Barranco A, Alberola Terol V, Espuch Núñez D, Martín del Guayo G, Infante Matarredona E. Surgical treatment of primary hyperparathyroidism: A descriptive analysis. Acta Otorrinolaringol Esp 2004;55:288-94.
  • 10 Ferrer Baixauli F, Severa Ferrandiz G, Menor Ibanez F, Infante Matarredona E. PTHi value in the surgical treatment of hyperparathyroidism. An Otorrinolaringol Ibero Am 2004;31:609-19.
  • 11 Yang ZQ, Zhu LW, Wang PZ. Diagnosis and surgical treatment of 48 cases of parathyroid adenoma and parathyroid carcinoma. Zhonghua Zhong Liu Za Zhi 2006;28:625-7.
  • 12 Barna I, Varadi A, Lakatos P. Metabolic abnormalities related to cardiovascular risk in primary hyperparathyroidism: Effects of surgical treatment. J Intern Med 1999;245:311-3.
  • 13 Hedback G, Oden A, Tisell LE. Parathyroid adenoma weight and the risk of death after treatment for primary hyperparathyroidism. Surgery 1995;117:134-9.
  • 14 Andersson P, Rydberg E, Willenheimer R. Primary hyperparathyroidism and heart disease: A review. Eur Heart J 2004;25:1776-87.
  • 15 Garcia de la Torre N, Wass JA, Turner HE. Parathyroid adenomas and cardiovascular risk. Endocr Relat Cancer 2003;10:309-22.
  • 16 Smith JC, Page MD, John R, Wheeler MH, Cockcroft JR, Scanlon MF, et al. Augmentation of central arterial pressure in mild primary hyperparathyroidism. J Clin Endocrinol Metab 2000;85:3515-9.
  • 17 Nilsson IL, Aberg J, Rastad J, Lind L. Endothelial vasodilatory dysfunction in primary hyperparathyroidism is reversed after parathyroidectomy. Surgery 1999;126:1049-55.