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Suppressibility of serum levels of PTH by calcium in the immediate postoperative period after surgery for primary hyperparathyroidism

Bergenfelz, A LU and Ahrén, B LU (1993) In World Journal of Surgery 17(6). p.10-806
Abstract

The ability of calcium to suppress the secretion of parathyroid hormone (PTH) is impaired in primary hyperparathyroidism (pHPT). Whether the nonadenomatous glands in pHPT also exhibit altered calcium/PTH homeostasis is not known, but this may be the case since in the immediate postoperative period after surgery for pHPT, hypocalcemia often evolves in spite of a rapid normalization of serum levels of PTH. In this study, therefore, the suppression of serum levels of PTH by an oral calcium load was investigated pre- and postoperatively in 12 patients operated on for parathyroid adenoma. There was no difference in the calcemic response during the calcium load pre- and postoperatively. We found that the suppression of serum levels of PTH by... (More)

The ability of calcium to suppress the secretion of parathyroid hormone (PTH) is impaired in primary hyperparathyroidism (pHPT). Whether the nonadenomatous glands in pHPT also exhibit altered calcium/PTH homeostasis is not known, but this may be the case since in the immediate postoperative period after surgery for pHPT, hypocalcemia often evolves in spite of a rapid normalization of serum levels of PTH. In this study, therefore, the suppression of serum levels of PTH by an oral calcium load was investigated pre- and postoperatively in 12 patients operated on for parathyroid adenoma. There was no difference in the calcemic response during the calcium load pre- and postoperatively. We found that the suppression of serum levels of PTH by calcium was increased already on the first postoperative day. However, postoperatively, the suppression of serum levels of PTH correlated positively to serum levels of ionized calcium and, furthermore, negatively to the weight of the excised parathyroid adenoma and the preoperative serum levels of ionized calcium. The results indicate that the function of the remaining parathyroid glands in patients with parathyroid adenoma could have been altered during the hyperparathyroid state and that postoperative hypocalcemia more readily evolves in patients with severe pHPT and impaired suppressibility of PTH (by calcium) in the remaining parathyroid glands.

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publication status
published
subject
keywords
Administration, Oral, Aged, Calcium, Female, Humans, Hyperparathyroidism, Male, Parathyroid Hormone, Postoperative Period, Journal Article, Research Support, Non-U.S. Gov't
in
World Journal of Surgery
volume
17
issue
6
pages
10 - 806
publisher
Springer
external identifiers
  • scopus:0027730550
ISSN
0364-2313
language
English
LU publication?
yes
id
d0215eb7-26bf-41f2-9a74-931f3a6a4c93
date added to LUP
2017-05-10 17:44:50
date last changed
2017-08-22 17:00:53
@article{d0215eb7-26bf-41f2-9a74-931f3a6a4c93,
  abstract     = {<p>The ability of calcium to suppress the secretion of parathyroid hormone (PTH) is impaired in primary hyperparathyroidism (pHPT). Whether the nonadenomatous glands in pHPT also exhibit altered calcium/PTH homeostasis is not known, but this may be the case since in the immediate postoperative period after surgery for pHPT, hypocalcemia often evolves in spite of a rapid normalization of serum levels of PTH. In this study, therefore, the suppression of serum levels of PTH by an oral calcium load was investigated pre- and postoperatively in 12 patients operated on for parathyroid adenoma. There was no difference in the calcemic response during the calcium load pre- and postoperatively. We found that the suppression of serum levels of PTH by calcium was increased already on the first postoperative day. However, postoperatively, the suppression of serum levels of PTH correlated positively to serum levels of ionized calcium and, furthermore, negatively to the weight of the excised parathyroid adenoma and the preoperative serum levels of ionized calcium. The results indicate that the function of the remaining parathyroid glands in patients with parathyroid adenoma could have been altered during the hyperparathyroid state and that postoperative hypocalcemia more readily evolves in patients with severe pHPT and impaired suppressibility of PTH (by calcium) in the remaining parathyroid glands.</p>},
  author       = {Bergenfelz, A and Ahrén, B},
  issn         = {0364-2313},
  keyword      = {Administration, Oral,Aged,Calcium,Female,Humans,Hyperparathyroidism,Male,Parathyroid Hormone,Postoperative Period,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  month        = {11},
  number       = {6},
  pages        = {10--806},
  publisher    = {Springer},
  series       = {World Journal of Surgery},
  title        = {Suppressibility of serum levels of PTH by calcium in the immediate postoperative period after surgery for primary hyperparathyroidism},
  volume       = {17},
  year         = {1993},
}