Article

Parathyroid hormone: an early predictor of symptomatic hypocalcemia after total thyroidectomy.

Head and Neck Surgery, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.
Arquivos brasileiros de endocrinologia e metabologia (impact factor: 0.68). 04/2012; 56(3):168-72. pp.168-72
Source: PubMed

ABSTRACT The purpose of this study was to evaluate if the measurement of peri-operative parathyroid hormone (PTH) is able to identify patients with increased risk of developing symptoms of hypocalcemia.
Forty patients who underwent total thyroidectomy were studied prospectively. Ionized serum calcium and PTH were measured after induction of anesthesia, one hour (PTH1) and one day after surgery (PTH24). Patients were evaluated for symptoms of hypocalcemia and treated with calcium and vitamin D supplementation as necessary.
Symptomatic hypocalcemia developed in 16 patients. Symptomatic patients had significant lower PTH1 and greater drops in PTH levels. The selection of 12.1 ng/L as PTH1 level cutoff level divided patients with and without symptoms with 93.7% sensitivity and 91.6% specificity. The selection of 73.5% as the cutoff value for PTH decrease resulted in 91.6% sensitivity and 87.5% specificity.
PTH1 levels and the drop in PTH levels are reliable predictors of developing symptomatic hypocalcemia after total thyroidectomy.

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Keywords

16 patients
 
cutoff value
 
greater
 
hypocalcemia
 
induction
 
Ionized serum calcium
 
necessary
 
patients
 
peri-operative parathyroid hormone
 
PTH decrease
 
PTH levels
 
PTH1
 
PTH1 level cutoff level
 
PTH1 levels
 
Symptomatic hypocalcemia
 
Symptomatic patients
 
symptoms
 
total thyroidectomy
 
vitamin D supplementation