Functional recovery of the parathyroid glands after surgery for primary hyperparathyroidism

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Functional recovery of the parathyroid glands after surgery for primary hyperparathyroidism. / Bergenfelz, A; Valdermarsson, S; Ahrén, B.

In: Surgery, Vol. 116, No. 5, 11.1994, p. 827-36.

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TY - JOUR

T1 - Functional recovery of the parathyroid glands after surgery for primary hyperparathyroidism

AU - Bergenfelz, A

AU - Valdermarsson, S

AU - Ahrén, B

PY - 1994/11

Y1 - 1994/11

N2 - BACKGROUND: The immediate postoperative function of the parathyroid glands after surgery for primary hyperparathyroidism (pHPT) has not been established. We therefore examined the influences of hypercalcemia and hypocalcemia on serum parathyroid hormone (PTH) levels in the immediate postoperative period in patients with pHPT.METHODS: Ethylenediaminetetraacetic acid was infused in patients on the first (n = 5) and fourth (n = 6) postoperative days, and in patients at 1 year after surgery (n = 6), and in healthy subjects (n = 7). Calcium was given orally before operation and on the second and fifth postoperative days in six patients and in seven healthy subjects.RESULTS: The increased set point seen in pHPT was normalized on the first postoperative day, and the decreased PTH suppressibility by calcium was normal on the second postoperative day. However, on the fifth postoperative day an increased suppressibility of PTH was evident. During the ethylenediaminetetraacetic acid infusion test the secretory reserve for PTH increased after operation with increasing hypocalcemia-induced levels of intact PTH between the first and fourth postoperative days (p < 0.001), and between the fourth postoperative day and the test at 1 year (p < 0.05).CONCLUSIONS: In the immediate postoperative period after surgery for pHPT, baseline serum levels of PTH are rapidly normalized; this is followed by an increase in the secretory reserve for PTH secretion and the development of an increased sensitivity to calcium.

AB - BACKGROUND: The immediate postoperative function of the parathyroid glands after surgery for primary hyperparathyroidism (pHPT) has not been established. We therefore examined the influences of hypercalcemia and hypocalcemia on serum parathyroid hormone (PTH) levels in the immediate postoperative period in patients with pHPT.METHODS: Ethylenediaminetetraacetic acid was infused in patients on the first (n = 5) and fourth (n = 6) postoperative days, and in patients at 1 year after surgery (n = 6), and in healthy subjects (n = 7). Calcium was given orally before operation and on the second and fifth postoperative days in six patients and in seven healthy subjects.RESULTS: The increased set point seen in pHPT was normalized on the first postoperative day, and the decreased PTH suppressibility by calcium was normal on the second postoperative day. However, on the fifth postoperative day an increased suppressibility of PTH was evident. During the ethylenediaminetetraacetic acid infusion test the secretory reserve for PTH increased after operation with increasing hypocalcemia-induced levels of intact PTH between the first and fourth postoperative days (p < 0.001), and between the fourth postoperative day and the test at 1 year (p < 0.05).CONCLUSIONS: In the immediate postoperative period after surgery for pHPT, baseline serum levels of PTH are rapidly normalized; this is followed by an increase in the secretory reserve for PTH secretion and the development of an increased sensitivity to calcium.

KW - Adenoma

KW - Adult

KW - Analysis of Variance

KW - Calcium

KW - Edetic Acid

KW - Female

KW - Humans

KW - Hyperparathyroidism

KW - Male

KW - Middle Aged

KW - Parathyroid Glands

KW - Parathyroid Hormone

KW - Parathyroid Neoplasms

KW - Postoperative Period

KW - Time Factors

KW - Comparative Study

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

M3 - Article

VL - 116

SP - 827

EP - 836

JO - Surgery

JF - Surgery

SN - 1532-7361

IS - 5

ER -