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

نویسندگان

  • Felipe Augusto Brasileiro Vanderlei
  • Jose Gilberto Henriques Vieira
  • Flavio Carneiro Hojaij
  • Onivaldo Cervantes
  • Ilda Sizue Kunii
  • Monique Nakayama Ohe
  • Rodrigo Oliveira Santos
  • Marcio Abrahão
چکیده

OBJECTIVE 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. SUBJECTS AND METHODS 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. RESULTS 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. CONCLUSION PTH1 levels and the drop in PTH levels are reliable predictors of developing symptomatic hypocalcemia after total thyroidectomy.

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منابع مشابه

Is Decline Rate of Intact Parathyroid Hormone Level a Reliable Criterion for Early Discharge of Patients after Total Thyroidectomy?

Introduction: Parathyroid dysfunction leading to symptomatic hypocalcemia is not uncommon following a total thyroidectomy and is often associated with significant patient morbidity and a prolonged hospital stay. The current study aimed at evaluating the comparative predictive role of serum calcium and intact parathyroid hormone (iPTH) for post-thyroidectomy hypocalcemia.   Materials and Methods...

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Parathyroid hormone levels 1 hour after thyroidectomy: an early predictor of postoperative hypocalcemia.

BACKGROUND Parathyroid dysfunction leading to symptomatic hypocalcemia is not uncommon following a total or completion thyroidectomy and is often associated with significant patient morbidity and a prolonged hospital stay. A simple, reliable indicator to identify patients at risk would permit earlier pharmacologic prophylaxis to avoid these adverse outcomes. We examined the role of intact parat...

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Reliable Early Prediction for Different Types of Post-Thyroidectomy Hypocalcemia

OBJECTIVES High incidence of hypocalcemia after thyroidectomy is a major determinant in delay of discharge. Even though many studies have focused on the search for reliable early predictors of postoperative hypocalcemia, definitions of hypocalcemia are diverse; therefore, interpretation and application of previously reported findings may not be easy. We aimed to elucidate diverse patterns of po...

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[Parathyroid hormone as a predictor of post-thyroidectomy hypocalcemia].

INTRODUCTION AND OBJECTIVE The risk of developing hypocalcemia is the reason for prolonged hospitalisation after total thyroidectomy. The objective of this study was to validate parathyroid hormone measurement for predicting post-thyroidectomy hypocalcemia. MATERIAL AND METHODS Eighty-two patients who underwent total or completion thyroidectomy from February 2009 to March 2010 were enrolled i...

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عنوان ژورنال:
  • Arquivos brasileiros de endocrinologia e metabologia

دوره 56 3  شماره 

صفحات  -

تاریخ انتشار 2012