ORIGINAL ARTICLE ELEVATED PARATHYROID HORMONE LEVELS AFTER PARATHYROIDECTOMY FOR PRIMARY HYPERPARATHYROIDISM

Abstract: Background. Curative parathyroidectomy is asso-ciated with elevated levels of parathyroid hormone (PTH) with eucalcemia. This study sought to determine the frequency, clinical significance, and risk factors of this finding. Methods. Seventy-six consecutive patients surgically treated for primary hyperparathyroidism due to a single para-thyroid adenoma in 2006 to 2007 were monitored for 1 month postoperatively; those with elevated PTH levels (>70 pg/mL) were monitored for 18 months. Results. Nineteen patients (25%) had high postoperative PTH levels with normal calcium levels. Compared with the remaining patients, this group had a significantly higher aver-age preoperative PTH level (224.89 vs 156.86 pg/mL) and a lesser intraoperative decrease in PTH. Conclusions. About 25 % of eucalcemic patients may have elevated PTH levels after parathyroidectomy. A high preopera-tive PTH level (>225 pg/mL) may predict a persistently high postoperative level. Evaluation of blood and urine calcium, bone density, and cardiac function should be considered i