Background And Aims: Hypocalcemia after thyroidectomy is caused by parathyroid trauma. There are no studies regarding the usefulness of intact parathyroid hormone (PTH) as a monitor of postoperative hypoparathyroidism tool in pediatrics. We evaluated the diagnostic accuracy of intra- and postoperative PTH to predict the risk of developing post thyroidectomy hypocalcemia in children.
Methods: A prospective longitudinal cohort study was conducted in 32 pediatric patients (3.2-17.6 years old) undergoing total thyroidectomy. Intact PTH measured by the assays (Immulite Immunoassay System [ICMA] or electrochemioluminescence assay [ECLIA]) at 5 (PTH-5) and 60 (PTH-60) minutes after thyroid removal were considered as predicting variables. The postoperative outcome was hypocalcemia (endpoint variable). Patients were clinically and biochemically monitored regularly for 48 hours after surgery.
Results: Of the patients, 47% developed hypocalcemia (15% symptomatic). An ICMA PTH-5 of ≤14 pg/mL or an ECLIA PTH-5 of ≤16 pg/mL predicted hypocalcemia with a sensitivity of 80%, specificity of 100%, positive predictive value (PPV) of 100%, and diagnostic efficiency (DE) of 91%. Using the same cutoff values, PTH-60 presented a sensitivity of 93%, specificity of 82%, PPV of 81%, and DE of 87%. Adjusting for variation in the assays and combining intra- and postoperative PTH determinations, we developed an algorithm that improved sensitivity, specificity, and DE.
Conclusion: PTH is useful for predicting hypocalcemia after total thyroidectomy in children. The use of our proposed strategy should be considered to (a) initiate preventive treatment in patients identified at high risk for hypocalcemia, (b) shorten the duration of hospitalization, and (c) reduce the clinical and biochemical controls in those who remained normocalcemic.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.surg.2014.02.016 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Factors associated with early onset hypocalcemia: A retrospective cohort study.
Pediatr Int
January 2025
Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Background: Early onset hypocalcemia, occurring within 3 days of birth, is prevalent among preterm infants. A central line is required to deliver calcium (Ca). The prediction of hypocalcemia is therefore clinically important when the requirement for initial intravascular calcium administration is anticipated.
View Article and Find Full Text PDFIonised calcium levels during trauma resuscitation in predicting outcomes-a prospective cohort study.
Eur J Trauma Emerg Surg
January 2025
Department of Biostatics, All India Institute of Medical Sciences, New Delhi, India.
Background: Haemorrhage remains the leading cause of preventable mortality following trauma, often aggravated by the acidosis, hypothermia and coagulopathy-the lethal triad of trauma. However, the impact of trauma-induced hypocalcemia on the haemorrhage remains unclear. It is intuitive to consider perturbations of ionised calcium early during trauma resuscitation in acutely injured patients given its pathophysiological significance for an improved outcome.
View Article and Find Full Text PDFPredictors of hypocalcemia among children admitted in the Emergency Pediatric Unit of the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.
Saudi Med J
January 2025
From the Department of Pediatrics (Imam, Musa), University of Maiduguri Teaching Hospital; from the Department of Pediatrics (Elechi, Rabasa), College of Medical Sciences, University of Maiduguri, Maiduguri; and from the Department of Pediatrics (Bakari), College of Medical Sciences, Modibo Adama University, Yola, Nigeria.
Objectives: To determine the prevalence and pattern of hypoglycemia among children admitted to the Emergency Pediatric Unit (EPU) at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.
Methods: A cross-sectional study was conducted between February and September 2020. Blood glucose, along with other relevant laboratory investigations, was measured for each patient upon admission to the EPU using a point-of-care test glucometer (ACCU-CHEK with strips).
Assessment of ICG fluorescence in identification and preservation of parathyroid glands in thyroid surgeries and correlation with postoperative parathormone and serum calcium levels.
Endocrine
January 2025
Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Introduction: Intraoperative parathyroid gland (PG) localization remains challenging during thyroid surgeries, contributing to postoperative hypocalcemia and hypoparathyroidism. This study assessed the efficacy of indocyanine green (ICG) fluorescence in identifying and preserving PGs during thyroid surgeries and its correlation with postoperative outcomes.
Materials And Methods: This ambispective observational study included 57 patients undergoing thyroid surgeries using ICG and compared outcomes with 56 historical controls.
US-Guided Thermal Ablation for Secondary Hyperparathyroidism: A Prospective Multicenter Study.
Radiology
January 2025
From the Department of Interventional Ultrasound, the Fifth Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Rd, Beijing 100853, China (Y.L., F.Y.L., J.Y., P.L.); Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China (C.Z.P.); Graduate Department, Bengbu Medical College, Bengbu, Anhui, China (H.H.C.); Department of Ultrasound, Capital Medical University, Beijing Friendship Hospital, Beijing, China (L.X.Q.); Department of Ultrasonography, Fujian Provincial Hospital, Fuzhou, Fujian, China (S.S.W.); Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); Department of Ultrasound, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China (S.P.L., J.T.Z.); Department of Ultrasound, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China (Y.S.); Weifang Peoples Hospital, Weifang, Shandong, China (C.B.S.); Daqing Oilfield General Hospital, Daqing, Liaoning, China (Z.W.Y., R.Z.); and Department of Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (Y.C., S.H.G.).
Background Interest in microwave ablation (MWA) and radiofrequency ablation (RFA) use for treating secondary hyperparathyroidism (SHPT) is rising; however, ablation outcomes in patients with SHPT are not well characterized. Purpose To assess the response of parathyroid hormone (PTH), calcium, phosphorus, and alkaline phosphatase (ALP) levels to US-guided parathyroid MWA and RFA and the safety of these treatments in participants with SHPT. Materials and Methods This prospective multicenter cohort study, conducted from September 2017 to March 2022, included participants with SHPT.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!