AI Article Synopsis
- The study investigates the differences in PTH (parathyroid hormone) levels during and after parathyroidectomy in patients with primary and secondary hyperparathyroidism (HPT) using a new whole PTH assay that specifically targets 1-84 PTH.
- Blood samples from 74 primary HPT patients and 18 secondary HPT patients were analyzed to compare PTH kinetics, revealing that whole PTH levels decreased faster than intact PTH in both groups.
- Results suggest the whole PTH assay could be more beneficial during surgeries for both types of HPT, compared to the commonly used intact PTH assay.
Article Abstract
Background: Most commercial intact parathyroid hormone (intact PTH) assays cross-react with non-(1-84) PTH (likely 7-84 PTH). Using a whole-molecule PTH (whole PTH) assay that specifically measured only 1-84 PTH, we compared the kinetics of whole PTH and intact PTH after parathyroidectomy in patients with primary hyperparathyroidism (HPT) and secondary HPT.
Methods: This study comprised 74 patients with primary HPT caused by a single adenoma and 18 patients with secondary HPT who underwent parathyroidectomy. Blood samples were drawn after anesthesia, just before excision of a single adenoma in primary HPT, and just before excision of the last parathyroid gland in secondary HPT, and at 5, 10, and 15 minutes after excision. The 7-84 PTH level was calculated by subtracting the whole PTH value from the intact PTH value.
Results: There was a difference between the percentage of 7-84 PTH/intact PTH in plasma samples from patients with primary HPT and secondary HPT (28%+/-12% vs 35%+/-9%; P<.05). Plasma whole PTH decreased more rapidly than intact PTH after parathyroidectomy in patients in both the primary HPT (P<.0001) and secondary HPT groups (P<.0001). Decline of intact PTH was slower in patients with secondary HPT than in patients with primary HPT; however, there was no significant difference in the decline of whole PTH between the 2 groups.
Conclusions: The quick intact PTH assay is not used frequently during surgery in patients with secondary HPT; however, our results suggest that a quick whole PTH assay may be a more useful adjunct to parathyroidectomy in both secondary HPT and primary HPT.
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| http://dx.doi.org/10.1016/s0039-6060(03)00387-8 | DOI Listing |
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