Persistent elevation of parathormone levels after surgery for primary hyperparathyroidism

Background: Persistent elevation of serum parathyroid hormone (PTH) despite normocalcemia have been documented in 8- 40% of patients after parathyroidectomy. We hereby report our experience from different centers across India to determine clinical significance of postoperatively elevated PTH levels...

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Published in:Indian journal of endocrinology and metabolism 2020-07, Vol.24 (4), p.366-372
Main Authors: Kota, Sunil, Kota, Siva, Jammula, Sruti, Bhargav, P, Sahoo, Abhay, Das, Sambit, Talluri, Satish, Kongara, Srikanth, S Krishna, S, Modi, K
Format: Article
Language:English
Subjects:
Creatinine
Hyperparathyroidism
Medical research
normocalcemia
Original
parathormone
Parathyroid hormones
parathyroidectomy
Phosphatase
Phosphates
primary hyperparathyroidism
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Summary:Background: Persistent elevation of serum parathyroid hormone (PTH) despite normocalcemia have been documented in 8- 40% of patients after parathyroidectomy. We hereby report our experience from different centers across India to determine clinical significance of postoperatively elevated PTH levels and review relevant literature. Methods: We conducted a retrospective case series study and reviewed all the patients who underwent surgery for primary hyperparathyroidism (PHPT) from April 2010 to January 2020. Results: Total of 201 patients was diagnosed as PHPT. Out of available follow-up data of 180 patients, a total of 54 patients (30%) had persistently elevated PTH (PePTH) at 1 month. Patients with PePTH were older with higher preoperative serum calcium, iPTH, alkaline phosphatase and lower serum phosphate and 25-hydroxy vitamin D3 levels. Creatinine clearance was found to be significantly lower in patients with PePTH. Multiple linear regression analysis revealed that preoperative 25-OH D3 concentration, creatinine clearance and iPTH are the factors influencing persistent elevation of PTH levels. Significantly lower serum calcium and higher alkaline phosphatase levels were observed in PePTH patients with preoperative 25-OH D3 levels
ISSN:2230-8210
2230-9500
DOI:10.4103/ijem.IJEM_212_20