High parathyroid hormone levels after parathyroidectomy for parathyroid adenoma are not related to the cellularity of the remaining glands

Laryngoscope Investigative Otolaryngology

article

Rotem Sagiv MD¹  Bertha Delgado MD²  Re'em Sadeh MD³  Sagi Shashar MD³  Merav Fraenkel MD⁴  Ksenia M. Yegodayev MSc⁵  Moshe Elkabets PhD⁵  Ben-Zion Joshua MD, MBA⁶ 

[1] Joyce & Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev;Pathology Unit, Soroka University Medical Center;Clinical Research Center of Soroka Medical Center;Endocrinology Unit, Soroka University Medical Center;Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev;Department of Otorhinolaryngology – Head and Neck Surgery, Barzilai Medical Center

关键词: cellularity;    elevated PTH levels;    parathyroid adenoma;    parathyroid hyperplasia;    parathyroidectomy;   

DOI  :  10.1002/lio2.644

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

Background Patients with primary hyperparathyroidism (PHPT) treated surgically occasionally have normalized calcium, but persistently high parathyroid hormone (PTH). We hypothesized that a possible explanation for this phenomenon is an underlying hyperplasia rather than adenoma. Methods Retrospective cohort of patients who underwent parathyroidectomy for PHPT with biopsy of a normal-appearing parathyroid gland were included. Cellularity level of each biopsy and of the adenoma's rim was determined. Results Forty-seven patients were included. Of them, 19 (40%) had postoperative normocalcemia but elevated PTH. There was no correlation between cellularity either in the rim or of the normal-appearing parathyroid gland and postoperative PTH. The postoperative high PTH group had higher preoperative PTH ( P  = 0.001) and larger adenomas ( P  = 0.025). Conclusions High PTH levels after successful parathyroidectomy in patients with primary hyperparathyroidism do not appear to result from underlying hyperplasia. A possible alternative explanation is that these patients have a higher preoperative burden of disease.

【 授权许可】

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