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Intact parathyroid hormone measurement at 24 hours after thyroid surgery as predictor of parathyroid function at long term.
Am J Surg ; 206(5): 783-9, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23835208


There is no consensus about the usefulness of postoperative intact parathyroid hormone (iPTH) determination to predict permanent hypoparathyroidism (pHPP). We evaluated the value of calcium (Ca2+) and iPTH concentration at 24 hours after total thyroidectomy (TT) for predicting pHPP.


Ca2+ and iPTH levels from 70 consecutive patients who underwent TT were measured at 24 hours and 6 months after TT.


Five patients (7.1%) developed pHPP. An iPTH concentration ≤5.8 pg/mL at 24 hours after TT identified patients at risk for pHPP (sensitivity, 100%; specificity, 81.5%), but it was not accurate enough to predict its development (positive predictive value, 30%). Conversely, an iPTH level >5.8 pg/mL predicted normal parathyroid function at 6 months (negative predictive value, 100%). Compared with iPTH, a postoperative Ca2+ level ≤1.95 mmol/L was 60% sensitive and 78.5% specific to predict pHPP.


An iPTH concentration >5.8 pg/mL on the first postoperative day rules out pHPP with much better diagnostic accuracy than Ca2+. Postoperative iPTH could be helpful in identifying patients at risk for developing pHPP.





Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Hormônio Paratireóideo / Tireoidectomia / Cálcio / Hipoparatireoidismo Aspecto clínico: Diagnóstico / Etiologia / Predição / Prognóstico Limite: Feminino / Humanos / Masculino / Meia-Idade Idioma: Inglês Revista: Am J Surg Ano de publicação: 2013 Tipo de documento: Artigo