scholarly journals Predictive Factors for Early Postoperative Hypocalcemia After Surgery for Primary Hyperparathyroidism

2009 ◽  
Vol 22 (2) ◽  
pp. 124-127 ◽  
Author(s):  
Shawn Steen ◽  
Brandon Rabeler ◽  
Tammy Fisher ◽  
David Arnold
Keyword(s):  
Primary Hyperparathyroidism ◽  
Predictive Factors ◽  
Postoperative Hypocalcemia

scholarly journals Sporadic primary hyperparathyroidism with multiple parathyroid adenomas

2021 ◽  
Vol 67 (6) ◽  
pp. 31-38
Author(s):  
E. E. Bibik ◽  
A. K. Eremkina ◽  
O. A. Knyazeva ◽  
N. G. Mokrysheva
Keyword(s):  
Primary Hyperparathyroidism ◽  
Life Quality ◽  
Dynamic Monitoring ◽  
Postoperative Hypocalcemia ◽  
Target Organs ◽  
Parathyroid Adenomas ◽  
Active Observation ◽  
Sporadic Primary Hyperparathyroidism ◽  
The Right ◽  
Hungry Bone

Multiple lesions of the parathyroid glands (PTG) in primary hyperparathyroidism (PHPT) can be sporadic or develop as part of hereditary syndromes, manifesting at young age. There the description of a severe sporadic PHPT with big parathyroid neoplasms in the young patient is presented. Clinical data made it possible to suspect MEN-1 syndrome or parathyroid carcinomas; however, mutations CDKN, CDC73, MEN1 were excluded. The patient underwent removal of three identified tumors: benign adenomas of the left PTG and hyperplasia of the right one. Postoperative hypocalcemia and severe hungry bone syndrome required the administration of vitamin D and calcium carbonate preparations. However, a year after the operation, a «mild» recurrent disease was confirmed. Taking into account the patient’s refusal to reoperation and a significant improvement of the target organs state, active observation was continued. The patient needs further careful dynamic monitoring by specialists in order to timely identify indications for repeated surgical treatment to improve the life quality and span.

scholarly journals Analyses of Predictive Factors Associated with Hypocalcemia and Elevated iPTH with Normocalcemia after Ultrasound-guided Radiofrequency Ablation for Primary Hyperparathyroidism

2021 ◽  
Author(s):  
Hui-Hui Chai ◽  
Yu Zhao ◽  
Rui-Zhong Ye ◽  
Zeng Zeng ◽  
Zheng-Xian Zhang ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Radiofrequency Ablation ◽  
Primary Hyperparathyroidism ◽  
Predictive Factors ◽  
Elevated Serum ◽  
Intact Parathyroid Hormone ◽  
Ultrasound Guided ◽  
Serum Ipth ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

Abstract Purpose To assess the feasibility of ultrasound-guided (US-guided) radiofrequency ablation (RFA) for primary hyperparathyroidism (PHPT) and determine predictive factors for hypocalcemia and elevated serum intact parathyroid hormone(ePTH) with normocalcemia after ablation. Materials and Methods Between January 2015 and January 2021, data from 44 patients with PHPT who were treated with US-guided RFA were retrospectively evaluated. Serum intact parathyroid hormone(iPTH), total calcium (Ca), phosphorus, alkaline phosphatase (ALP), and 25-hydroxyvitamin D3 (25(OH)D3) levels and the volume of the abnormal enlarged parathyroid glands were recorded before RFA. Changes in iPTH and Ca levels at 1 and 3 days, and, 1, 3, and 6 months after ablation were recorded. Results Overall, thirteen patients developed hypocalcemia 1–3 days after RFA. ePTH with normocalcemia developed in 17 patients 1 month after RFA. Thirty-two patients were followed up for more than 6 months, and 27 of these patients had sustained normalized values for both serum iPTH and Ca levels more than 6 months after RFA. There were significantly more patients who developed hypocalcaemia, when the baseline ALP was greater than 261.5 U/L (sensitivity 61.5%, specificity 100.0%). The risk of ePTH decreased by 21.7% for every 1 ng/mL increase in 25 (OH) D3. The risk of ePTH was increased when a patient's serum iPTH was higher than 172.4 pg/mL (sensitivity 88.2%, specificity 76.2%). Conclusions US-guided RFA is feasible for clinical management of PHPT patients. Hypocalcaemia following RFA was associated with higher pre-RFA serum ALP levels. Elevated iPTH levels with normocalcemia at 1 month after RFA were associated with pre-RFA vitamin D deficiency and higher baseline iPTH levels. Patients with higher serum ALP and iPTH and lower 25 (OH) D3 levels before RFA need to be managed carefully and monitored closely after RFA of PHPT.

scholarly journals Preoperative Predictive Factors for Parathyroid Carcinoma in Patients with Primary Hyperparathyroidism

2012 ◽  
Vol 27 (8) ◽  
pp. 890 ◽  
Author(s):  
Jae Hyun Bae ◽  
Hyung Jin Choi ◽  
Yenna Lee ◽  
Min Kyong Moon ◽  
Young Joo Park ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Predictive Factors ◽  
Parathyroid Carcinoma

scholarly journals Predictive Factors for Postoperative Severe Hypocalcaemia after Parathyroidectomy for Primary Hyperparathyroidism

2012 ◽  
Vol 78 (3) ◽  
pp. 352-358 ◽  
Author(s):  
Nicola Crea ◽  
Giacomo Pata ◽  
Claudio Casella ◽  
Carlo Cappelli ◽  
Bruno Salerni
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Predictive Factors ◽  
Clinical Symptoms ◽  
Several Variables ◽  
Group A ◽  
Group B ◽  
Intraoperative Parathyroid Hormone ◽  
Severe Hypocalcaemia ◽  
Postoperative Hypocalcaemia

Hypocalcaemia is a complication of parathyroidectomy. We retrospectively analyzed data on patients who underwent parathyroidectomy for primary hyperparathyroidism (pHPT) to identify predictive factors for severe postoperative hypocalcaemia. Since 2004 we performed 87 parathyroidectomies for pHPT. We divided the patients into two groups: subjects who presented with postoperative hypocalcaemia (group B) or otherwise (group A). We looked for a correlation between several variables and the incidence of postoperative hypocalcaemia. The median calcemia in group B (19 patients) was 6.9 mg/dL on the first postoperative day and 7.6 mg/dL on the third day. We observed hypocalcemia related clinical symptoms in every patient. In all 19 cases the reduction of intraoperative parathyroid hormone above 85 per cent after parathyroidectomy was related to the development of severe postoperative hypocalcaemia ( P = 0.042). We found that the reduction of intraoperative parathyroid hormone over 85 per cent after parathyroidectomy can be considered a reliable predictive factor of postoperative hypocalcaemia after parathyroidectomy for primary hyperparathyroidism.

scholarly journals Predictors of early postoperative hypocalcemia in patients with secondary hyperparathyroidism undergoing total parathyroidectomy

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110150
Author(s):  
Wei Gong ◽  
Yaqi Lin ◽  
Yu Xie ◽  
Zilu Meng ◽  
Yudong Wang
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Serum Calcium ◽  
Predictive Factors ◽  
Clinical Symptoms ◽  
Total Parathyroidectomy ◽  
Postoperative Hypocalcemia ◽  
Preoperative Serum ◽  
Calcium Phosphorus ◽  
Risk Patients ◽  
Study Population

Objective To summarize the clinical features of secondary hyperparathyroidism (SHPT) in patients with chronic renal failure and to explore the predictive factors of postoperative hypocalcemia after total parathyroidectomy in these patients. Methods The clinical data of 87 patients admitted to Guangdong Electric Power Hospital from May 2013 to February 2020 were reviewed. All patients underwent total parathyroid resection and sternocleidomastoid microtransplantation. Age, sex, and the serum calcium, phosphorus, alkaline phosphatase (ALP), and intact parathyroid hormone (iPTH) concentrations were analyzed as predictive factors of postoperative hypocalcemia. Results Bone pain was the most common clinical manifestation in this study population, and all 87 patients experienced relief from their clinical symptoms after the surgical procedure. Age and the preoperative serum calcium, ALP, and iPTH concentrations were determined to be early predictive factors of postoperative hypocalcemia. Conclusions Age and the preoperative calcium, ALP, and iPTH concentrations are independent risk factors for postoperative hypocalcemia in patients with SHPT and renal disease who undergo total parathyroidectomy with sternocleidomastoid microtransplantation. These factors can help identify high-risk patients who can be managed by a multidisciplinary team to improve graft survival and quality of life.

Hypocalcemia after Neck Exploration for Untreated Primary Hyperparathyroidism

2006 ◽  
Vol 72 (12) ◽  
pp. 1234-1237 ◽  
Author(s):  
C. Adam Conn ◽  
Jonathan Clark ◽  
Jeffrey Bumpous ◽  
Richard Goldstein ◽  
Muffin Fleming ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Primary Hyperparathyroidism ◽  
Postoperative Management ◽  
Bilateral Neck Exploration ◽  
Neck Exploration ◽  
Surgical Approaches ◽  
Postoperative Hypocalcemia ◽  
Duration Of Surgery ◽  
University Of Louisville ◽  
The University

Hypocalcemia after neck exploration for hyperparathyroidism is an important postoperative management issue. With increasing acceptance of less invasive surgical approaches, hypocalcemia is less frequent. This study was conducted to evaluate postoperative hypocalcemia after current surgical exploration techniques in patients with untreated primary hyperparathyroidism. From the University of Louisville parathyroid database, charts of patients undergoing surgery for untreated primary hyperparathyroidism from May 1, 1998 to May 30, 2004 were reviewed. Data was analyzed based on age, sex, preoperative calcium and parathyroid hormone levels, preexisting diseases, and extent of neck exploration. One hundred sixty-nine patients were identified with adequate data for analysis. Transient postoperative hypocalcemia occurred in 21 per cent (36/169) for the total group, in 18 per cent (22/125) after minimally invasive radio-guided parathyroidectomy, and in 32 per cent (14/44) after bilateral neck exploration. Patients with postoperative hypocalcemia had a statistically significant association with older age and pre-existing hypertension. Patients with postoperative hypocalcemia were more likely to have undergone longer surgical procedures and were more likely to have had pre-existing diabetes and mental disorders. These findings were not statistically significant and were considered trends. The frequency of osteoporosis in the hypocalcemia group was increased but was not significant. Transient hypocalcemia occurred in 21 per cent of patients after parathyroid surgery. It was more likely after bilateral neck exploration, a longer duration of surgery, and with hypertension, diabetes, and mental disorders.

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