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Large vein sampling for intact parathyroid hormone in preoperative localization of enlarged parathyroid glands

Bergenfelz, A LU ; Lundstedt, C LU ; Stridbeck, H LU and Ahrén, B LU (1992) In Acta radiologica (Stockholm, Sweden : 1987) 33(6). p.31-528
Abstract

Unilateral neck exploration for primary hyperparathyroidism (pHPT) of old and high risk patients can be safely performed under local anesthesia, provided there is a correct preoperative side localization of the enlarged parathyroid gland. We performed large vein sampling and measured intact parathyroid hormones (PTH) with a new, highly sensitive immunoradiometric assay. The method was used before operation in 20 patients with pHPT. A unilateral positive gradient of serum PTH levels was obtained in 15 patients. At surgery, 13 of these (87%) proved to be correct, i.e., the adenoma was localized on the same side. Thus, the technique correctly lateralized the parathyroid adenoma in 65% of the patients. We conclude that large vein sampling... (More)

Unilateral neck exploration for primary hyperparathyroidism (pHPT) of old and high risk patients can be safely performed under local anesthesia, provided there is a correct preoperative side localization of the enlarged parathyroid gland. We performed large vein sampling and measured intact parathyroid hormones (PTH) with a new, highly sensitive immunoradiometric assay. The method was used before operation in 20 patients with pHPT. A unilateral positive gradient of serum PTH levels was obtained in 15 patients. At surgery, 13 of these (87%) proved to be correct, i.e., the adenoma was localized on the same side. Thus, the technique correctly lateralized the parathyroid adenoma in 65% of the patients. We conclude that large vein sampling with measurement of intact PTH is a potentially useful investigation for preoperative side localization of parathyroid adenomas in pHPT patients scheduled for unilateral surgery under local anesthesia. However, prior to routine bilateral neck exploration large vein sampling is not justified.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Aged, Blood Specimen Collection, Female, Humans, Hyperparathyroidism, Male, Middle Aged, Parathyroid Hormone, Parathyroid Neoplasms, Preoperative Care, Veins, Journal Article
in
Acta radiologica (Stockholm, Sweden : 1987)
volume
33
issue
6
pages
4 pages
publisher
John Wiley & Sons
external identifiers
  • scopus:0026492474
ISSN
0284-1851
DOI
10.1177/028418519203300605
language
English
LU publication?
no
id
839bdfc4-195c-4758-868b-8af2c9fce915
date added to LUP
2017-05-10 17:47:45
date last changed
2019-01-06 13:09:52
@article{839bdfc4-195c-4758-868b-8af2c9fce915,
  abstract     = {<p>Unilateral neck exploration for primary hyperparathyroidism (pHPT) of old and high risk patients can be safely performed under local anesthesia, provided there is a correct preoperative side localization of the enlarged parathyroid gland. We performed large vein sampling and measured intact parathyroid hormones (PTH) with a new, highly sensitive immunoradiometric assay. The method was used before operation in 20 patients with pHPT. A unilateral positive gradient of serum PTH levels was obtained in 15 patients. At surgery, 13 of these (87%) proved to be correct, i.e., the adenoma was localized on the same side. Thus, the technique correctly lateralized the parathyroid adenoma in 65% of the patients. We conclude that large vein sampling with measurement of intact PTH is a potentially useful investigation for preoperative side localization of parathyroid adenomas in pHPT patients scheduled for unilateral surgery under local anesthesia. However, prior to routine bilateral neck exploration large vein sampling is not justified.</p>},
  author       = {Bergenfelz, A and Lundstedt, C and Stridbeck, H and Ahrén, B},
  issn         = {0284-1851},
  keyword      = {Aged,Blood Specimen Collection,Female,Humans,Hyperparathyroidism,Male,Middle Aged,Parathyroid Hormone,Parathyroid Neoplasms,Preoperative Care,Veins,Journal Article},
  language     = {eng},
  number       = {6},
  pages        = {31--528},
  publisher    = {John Wiley & Sons},
  series       = {Acta radiologica (Stockholm, Sweden : 1987)},
  title        = {Large vein sampling for intact parathyroid hormone in preoperative localization of enlarged parathyroid glands},
  url          = {http://dx.doi.org/10.1177/028418519203300605},
  volume       = {33},
  year         = {1992},
}