You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT ARCHIVES
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 143 No. 7, July 2008 TABLE OF CONTENTS
  Archives
  •  Online Features
  Paper
 This Article
 •Full text
 •PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citing articles on HighWire
 •Citing articles on Web of Science (3)
 •Contact me when this article is cited
 Related Content
 •Related letters
 •Similar articles in this journal
 Topic Collections
 •Otolaryngology/ Head & Neck Surgery
 •Endocrine Surgery
 •Prognosis/ Outcomes
 •Endocrine Diseases
 •Thyroid/ Parathyroid Diseases
 •Alert me on articles by topic
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit Add to Technorati Add to Twitter What's this?

Long-term Outcome of Patients With Elevated Parathyroid Hormone Levels After Successful Parathyroidectomy for Sporadic Primary Hyperparathyroidism

Carmen C. Solorzano, MD; William Mendez, MD; John I. Lew, MD; Steven E. Rodgers, MD, PhD; Raquel Montano, BS; Denise M. Carneiro-Pla, MD; George L. Irvin III, MD

Arch Surg. 2008;143(7):659-663.

Hypothesis  Untreated long-term elevated parathyroid hormone (PTH) levels after successful parathyroidectomy may predict recurrent hyperparathyroidism (HPT). Although elevated PTH levels have been reported in eucalcemic patients after parathyroidectomy for sporadic primary HPT, the long-term clinical significance of this finding remains unclear.

Design  Retrospective case series.

Setting  Tertiary referral center.

Patients  Five hundred seventy-six consecutive patients with HPT.

Intervention  Parathyroidectomy guided by intraoperative monitoring of PTH levels.

Main Outcome Measures  Overall incidence of elevated PTH levels (measurements of ≥ 70 pg/mL at any time during follow-up) and recurrent HPT (hypercalcemia and elevated PTH levels more than 6 months after parathyroidectomy).

Results  Of the 505 patients who underwent successful parathyroidectomy in this series and were followed up for more than 6 months, 337 (66.7%) consistently had PTH levels within the reference range, and 168 (33.3%) had elevated PTH levels. Of the 168 patients with elevated PTH levels, only 8 (4.8%) developed recurrent disease. The earliest recurrence occurred 2 years postoperatively. Factors associated with elevated PTH levels included advanced age, higher preoperative PTH levels, and mild postoperative renal insufficiency.

Conclusion  Although one-third of the patients had elevated PTH levels after successful parathyroidectomy, most of these patients with elevated PTH levels (95%) will achieve long-term eucalcemia.


Author Affiliations: Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida (Drs Solorzano, Mendez, Lew, Rodgers, and Irvin and Ms Montano); and Departments of Surgery, University of Puerto Rico School of Medicine, San Juan (Dr Mendez) and Medical University of South Carolina, Charleston (Dr Carneiro-Pla).



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?

RELATED LETTERS

Elevation of Parathyroid Hormone Levels in Children Who Underwent Parathyroidectomy for Hyperparathyroidism
Jirí Sedy
Arch Surg. 2009;144(1):92-93.
EXTRACT | FULL TEXT  

Elevation of Parathyroid Hormone Levels in Children Who Underwent Parathyroidectomy for Hyperparathyroidism—Reply
John I. Lew and Carmen C. Solorzano
Arch Surg. 2009;144(1):93.
EXTRACT | FULL TEXT  


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Elevation of Parathyroid Hormone Levels in Children Who Underwent Parathyroidectomy for Hyperparathyroidism--Reply
Lew and Solorzano
Arch Surg 2009;144:93-93.
FULL TEXT  

Elevation of Parathyroid Hormone Levels in Children Who Underwent Parathyroidectomy for Hyperparathyroidism
Sedy
Arch Surg 2009;144:92-93.
FULL TEXT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 2008 American Medical Association. All Rights Reserved.