Prediction of Transient and Permanent Hypoparathyroidism after Total Thyroidectomy Using the Postoperative Serum Parathyroid Hormone Test: When Is the Best Time to Check?

2017 ◽  
Vol 17 (3) ◽  
pp. 104 ◽  
Author(s):  
Hyunju Kim ◽  
Hyeong Won Yu ◽  
In Eui Bae ◽  
Jin Wook Yi ◽  
Joon-Hyop Lee ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Total Thyroidectomy ◽  
Permanent Hypoparathyroidism ◽  
Serum Parathyroid Hormone ◽  
Postoperative Serum

Parathyroid Hormone Levels Predict Posttotal Thyroidectomy Hypoparathyroidism

2014 ◽  
Vol 80 (8) ◽  
pp. 817-820 ◽  
Author(s):  
Amy E. Rivere ◽  
Ashton J. Brooks ◽  
Genevieve A. Hayek ◽  
Heng Wang ◽  
Ralph L. Corsetti ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Hospital Stay ◽  
Total Thyroidectomy ◽  
Recent Experience ◽  
Active Vitamin ◽  
Parathyroid Autotransplantation ◽  
Shorten Hospital Stay ◽  
Postoperative Serum ◽  
Pth Level

We hypothesized that parathyroid hormone (PTH) determination would be the most effective strategy to identify posttotal thyroidectomy hypoparathyroidism (PTTHP) compared with other clinical and laboratory parameters. We retrospectively reviewed our recent experience with total thyroidectomy. We recorded demographics, malignancy, thyroid weight, parathyroid autotransplantation, hospital stay, use of postoperative calcium and hormonally active vitamin D3 (calcitriol), and postoperative serum calcium and PTH levels. Patients were divided into two groups depending on whether supplemental calcitriol was required to maintain eucalcemia and therefore reflecting the diagnosis of PTTHP. From October 2010 to June 2013, a total of 202 total thyroidectomies were performed. Twenty-four patients (12%) developed PTTHP and required calcitriol replacement. Logistic regression analysis revealed that only postoperative calcium levels ( P = 0.02) and PTH levels ( P < 0.0001) statistically significantly predicted PTTHP. Twenty-two of 29 patients with PTH 13 pg/mL or less had PTTHP. Only two of 173 patients with a PTH level greater than 13 pg/mL were diagnosed with PTTHP. We recommend using PTH levels after total thyroidectomy to determine which patients will have hypoparathyroidism requiring calcitriol therapy. An early determination of PTTHP allows for prompt management that can shorten hospital stay and improve outcomes.

Impact of pre-operative serum 25-hydroxyvitamin D on post-operative serum calcium in patients undergoing total thyroidectomy for benign goitre: retrospective study of 246 patients

2017 ◽  
Vol 131 (10) ◽  
pp. 925-929 ◽  
Author(s):  
M Erlem ◽  
N Klopp-Dutote ◽  
A Biet-Hornstein ◽  
V Strunski ◽  
C Page
Keyword(s):  
Parathyroid Hormone ◽  
Retrospective Study ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Univariate Analysis ◽  
Multinodular Goitre ◽  
Serum Parathyroid Hormone ◽  
Single Centre ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

AbstractObjective:To determine whether pre-operative serum 25-hydroxyvitamin D has an impact on post-operative parathyroid hormone and serum calcium levels in patients undergoing total thyroidectomy for benign goitre.Methods:This single-centre, retrospective study comprised 246 unselected surgical patients who had undergone total thyroidectomy for bilateral, benign, multinodular goitre. The correlation between pre-operative serum 25-hydroxyvitamin D and post-operative serum parathyroid hormone and serum calcium was studied to determine whether low pre-operative serum 25-hydroxyvitamin D was predictive of post-operative hypocalcaemia.Results:Seventy-nine patients (32 per cent) had post-operative hypocalcaemia. Eighteen patients (7.32 per cent) experienced unintentional parathyroidectomy (1 parathyroid gland in 15 patients, 2 parathyroid glands in 3 patients). In univariate analysis, pre-operative serum 25-hydroxyvitamin D was not correlated with post-operative serum calcium (p = 0.69) or post-operative serum parathyroid hormone (p = 0.5804). Furthermore, in multivariate analysis, which took into account unintentional parathyroidectomy, no correlation was found (p = 0.33). Bilateral unintentional parathyroidectomy was statistically associated with post-operative hypocalcaemia (p = 0.032).Conclusion:Pre-operative serum 25-hydroxyvitamin D did not appear to have any impact on post-operative serum calcium in patients undergoing total thyroidectomy for benign goitre.

Same-day discharge after total thyroidectomy: The value of 6-hour serum parathyroid hormone and calcium levels

Head & Neck ◽  
2004 ◽  
Vol 27 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Richard J. Payne ◽  
Michael P. Hier ◽  
Michael Tamilia ◽  
Elizabeth Mac Namara ◽  
Jonathan Young ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Total Thyroidectomy ◽  
Serum Parathyroid Hormone ◽  
Same Day Discharge

scholarly journals Evaluation of Serum parathyroid hormone level measurement in total thyroidectomy patients

2020 ◽  
Vol 23 (1) ◽  
pp. 5-10
Author(s):  
Islam MS ◽  
Sultana T ◽  
Paul D ◽  
Huq AHMZ ◽  
Ferdoushi S ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Total Thyroidectomy ◽  
Hormone Level ◽  
Clinical Pathology ◽  
T Test ◽  
Parathyroid Hormone Level ◽  
Serum Parathyroid Hormone ◽  
Level Measurement ◽  
Postoperative Hypoparathyroidism ◽  
Serum Pth

Background: Postoperative hypoparathyroidism is a common complication after total thyroidectomy. It is necessary to diagnose hypoparathyroidism immediately after total thyroidectomy for minimizing complications. Objective: The objective of this study was to measure and to evaluate the serum parathyroid hormone level in total thyroidectomy patients. Methods: This prospective observational study was carried out in the Department of Clinical Pathology in collaboration with Department of Surgery & Department of Otolaryngology of BSMMU and Department of Otolaryngology of DMCH, Dhaka, during the period of September 2010 to August 2011. Results: Total 65 patients were studied irrespective of age and sex. Decreased serum PTH was found in 9 cases and normal parathyroid hormone was found in 56 cases. Male was 16.0% and female was 84.0%. Females were predominant. The incidence of hypoparathyroidism was 41.5%. Asymptomatic hypoparathyroidism was found in 8 and symptomatic hypoparathyroidism was found in 1 cases. Decreased serum PTH was developed mostly in malignant thyroid diseases. In relation to preoperative PTH values, intraoperative PTH levels were lower from 5.48% to 90.0%, (mean±SD in percentage is 65.3±16.7, p=.001) which is significant in paired t test. The mean difference of intraoperative (20 minutes after total thyroidectomy), parathyroid hormone levels were statistically significant (p<0.05) between patient with decreased parathyroid hormone and patient with normal parathyroid hormone in unpaired t-test. Conclusion: Serum parathyroid hormone level significantly decreased 20 minutes after total thyroidectomy. If clinical sign symptoms of hypoparathyroidism are not developed in postoperative period, patient is safe and can be discharged from hospital. Bangladesh J Otorhinolaryngol; April 2017; 23(1): 5-10

Serum levels of intact parathyroid hormone on the first day after total thyroidectomy as predictor of permanent hypoparathyroidism

2019 ◽  
Vol 66 (3) ◽  
pp. 195-201
Author(s):  
Pablo Calvo Espino ◽  
José Ángel Rivera Bautista ◽  
Mariano Artés Caselles ◽  
Javier Serrano González ◽  
Arturo García Pavía ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Total Thyroidectomy ◽  
Serum Levels ◽  
Intact Parathyroid Hormone ◽  
Permanent Hypoparathyroidism

scholarly journals Measurement of serum intact parathyroid hormone concentration 1 day after total thyroidectomy to assess risk of permanent hypoparathyroidism

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092719
Author(s):  
Jianwei Zheng ◽  
Shuyan Cai ◽  
Huimin Song ◽  
Yunlei Wang ◽  
Xiaofeng Han ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Total Thyroidectomy ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Intact Parathyroid Hormone ◽  
Permanent Hypoparathyroidism ◽  
Clinical Value ◽  
Predictive Risk Factor ◽  
Patients At Risk ◽  
Ipth Concentration

Objective This study was performed to assess the clinical value of measuring the intact parathyroid hormone (iPTH) concentration 1 day after total thyroidectomy to estimate the occurrence of permanent hypoparathyroidism (pHPP). Methods Data of 546 patients who underwent total thyroidectomy from February 2008 to December 2018 were retrospectively analyzed. Calcium and iPTH concentrations were collected preoperatively and at 1 day and 6 months postoperatively. Logistic regression was used to analyze the correlation between clinical indexes and postoperative pHPP. Results Of the 546 patients, 22 (4.03%) developed pHPP. Multivariate analysis showed that the iPTH and serum calcium concentrations measured 1 day after surgery were independent predictors of the risk of pHPP. An iPTH concentration of 5.51 pg/mL measured 1 day postoperatively was used as the cut-off value, and the area under the curve was 0.956. The risk of pHPP was identified with a sensitivity of 100%, specificity of 85.1%, positive predictive value of 22%, and negative predictive value of 100%. Conclusions The iPTH concentration measured 1 day after total thyroidectomy is closely related to the occurrence of pHPP postoperatively and is an independent predictive risk factor. The postoperative iPTH concentration can be helpful in identifying patients at risk for developing pHPP.

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