Details

Autor(en) / Beteiligte

• Sho, Shonan
• Kuo, Eric J.
• Chen, Angela C.
• Li, Ning
• Yeh, Michael W.
• Livhits, Masha J.

Titel

Biochemical and Skeletal Outcomes of Parathyroidectomy for Normocalcemic (Incipient) Primary Hyperparathyroidism

Ist Teil von

• Annals of surgical oncology, 2019-02, Vol.26 (2), p.539-546

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2019

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Background Normocalcemic (incipient) primary hyperparathyroidism (PHPT) is characterized by inappropriately elevated parathyroid hormone (PTH) levels in the setting of normal serum calcium. The biochemical and skeletal outcomes after parathyroidectomy for normocalcemic PHPT are not well-described. Methods All patients who underwent parathyroidectomy for normocalcemic PHPT at a single institution were retrospectively reviewed (2006–2016). Pre- and postoperative calcium, PTH, and bone mineral density (BMD) were compared between patients with normalized versus persistently elevated PTH levels > 6 months after parathyroidectomy. Multivariable Cox regression was used to identify risk factors associated with persistently elevated PTH levels after parathyroidectomy. Result Parathyroidectomy was performed in 71 patients with normocalcemic PHPT, of whom 38 (53.5%) had multi-gland disease. No patients became hypercalcemic, with a median follow-up of 23.1 months. Persistently elevated PTH levels were noted in 33 (46.5%) patients. In multivariable analysis, preoperative PTH > 100 pg/mL was associated with persistently elevated PTH levels after parathyroidectomy. In 38 patients with available pre- and postoperative BMD measurements, the mean preoperative BMD improved + 5.6% ( p  < 0.01) in patients with normalized PTH, while no significant change was observed in patients with persistently elevated PTH levels (− 2.2%, p  = 0.47). Conclusions Elevated PTH levels are common after parathyroidectomy for normocalcemic PHPT. Improvements in BMD may be predicated on long-term normalized PTH levels following surgery.