Utilidade da medida de PTH intra-operatório no tratamento cirúrgico do hiperparatiroidismo primário e secundário: análise de 109 casos

INTRODUCTION: Intraoperative parathyroid hormone measurement (IO-PTH) was first described in 1988 and it's potentially useful in predicting cure after parathyroidectomy. The aim of this study was to evaluate IO-PTH decay profile and the utility of this procedure in predicting cure in primary (P...

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Detalles Bibliográficos
Autores: Ohe, Monique Nakayama [UNIFESP], Santos, Rodrigo Oliveira [UNIFESP], Kunii, Ilda Shizue [UNIFESP], Abrahão, Márcio [UNIFESP], Cervantes, Onivaldo [UNIFESP], Carvalho, Aluizio Barbosa de [UNIFESP], Lazaretti-Castro, Marise [UNIFESP], Vieira, José Gilberto H. [UNIFESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2006
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:portugués
OAI Identifier:oai:repositorio.unifesp.br:11600/3306
Acceso en línea:http://dx.doi.org/10.1590/S0004-27302006000500007
http://repositorio.unifesp.br/handle/11600/3306
Access Level:acceso abierto
Palabra clave:Primary hyperparathyroidism
Secondary hyperparathyroidism
Parathyroid hormone
Intraoperative parathyroid hormone
Parathyroidectomy
Hiperparatiroidismo primário
Hiperparatiroidismo secundário
Hormônio paratiróideo
Hormônio paratiróideo intra-operatório
Paratiroidectomia
Descripción
Sumario:INTRODUCTION: Intraoperative parathyroid hormone measurement (IO-PTH) was first described in 1988 and it's potentially useful in predicting cure after parathyroidectomy. The aim of this study was to evaluate IO-PTH decay profile and the utility of this procedure in predicting cure in primary (PHH) and secondary (SHH) hyperparathyroidism due to renal disease. PATIENTS AND METHODS: 109 patients were evaluated from 06/2000 to 12/2004. 33 had PHH and 76 SHH (52 in dialysis, 24 with renal graft). IO-PTH was measured at times 0 (before resection), 10, 20 minutes after parathyroidectomy using immunometric assay (Elecsys-PTH/Immunoassay-Roche). Time necessary to perform assay: 10 minutes. RESULTS: HPP patients: IO-PTH average decrease 79.2% from basal levels after 10 minutes. HPS: IO-PTH average decrease 85.8% and 87.6% after 10 minutes in dialysis and renal graft patients respectively. All patients were cured, except 2 (1 PHH, 1 SHH), because of a double adenoma and ectopic (mediastinal) parathyroid respectively. Failure in IO-PTH decrease was observed in both. CONCLUSION: IO-PTH measurement is useful in improving surgical success rates in PHH and SHH.

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