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High parathyroid hormone levels after parathyroidectomy for parathyroid adenoma are not related to the cellularity of the remaining glands
Author(s) -
Sagiv Rotem,
Delgado Bertha,
Sadeh Re'em,
Shashar Sagi,
Fraenkel Merav,
Yegodayev Ksenia M.,
Elkabets Moshe,
Joshua BenZion
Publication year - 2021
Publication title -
laryngoscope investigative otolaryngology
Language(s) - English
Resource type - Journals
ISSN - 2378-8038
DOI - 10.1002/lio2.644
Subject(s) - medicine , parathyroidectomy , primary hyperparathyroidism , parathyroid hormone , adenoma , parathyroid adenoma , biopsy , hyperplasia , hyperparathyroidism , urology , endocrinology , calcium
Background Patients with primary hyperparathyroidism (PHPT) treated surgically occasionally have normalized calcium, but persistently high parathyroid hormone (PTH). We hypothesized that a possible explanation for this phenomenon is an underlying hyperplasia rather than adenoma. Methods Retrospective cohort of patients who underwent parathyroidectomy for PHPT with biopsy of a normal‐appearing parathyroid gland were included. Cellularity level of each biopsy and of the adenoma's rim was determined. Results Forty‐seven patients were included. Of them, 19 (40%) had postoperative normocalcemia but elevated PTH. There was no correlation between cellularity either in the rim or of the normal‐appearing parathyroid gland and postoperative PTH. The postoperative high PTH group had higher preoperative PTH ( P = 0.001) and larger adenomas ( P = 0.025). Conclusions High PTH levels after successful parathyroidectomy in patients with primary hyperparathyroidism do not appear to result from underlying hyperplasia. A possible alternative explanation is that these patients have a higher preoperative burden of disease.