Usefulness of a rapid immunometric assay for intraoperative parathyroid hormone measurements

Usefulness of a rapid immunometric assay for intraoperative parathyroid hormone measurements

Autor Ohe, Monique Nakayama Autor UNIFESP Google Scholar
Santos, Rodrigo Oliveira Autor UNIFESP Google Scholar
Kunii, I.s. Autor UNIFESP Google Scholar
Carvalho, A.b. Autor UNIFESP Google Scholar
Abrahão, Márcio Autor UNIFESP Google Scholar
Cervantes, Onivaldo Autor UNIFESP Google Scholar
Lazaretti-Castro, Marise Autor UNIFESP Google Scholar
Vieira, J.g.h. Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Intraoperative parathyroid hormone (IO-PTH) measurements have been proposed to improve operative success rates in primary, secondary and tertiary hyperparathyroidism (PHP, SHP and THP). Thirty-one patients requiring parathyroidectomy were evaluated retrospectively from June 2000 to January 2002. Sixteen had PHP, 7 SHP and 8 THP. Serum samples were taken at times 0 (before resection), 10, 20 and 30 min after resection of each abnormal parathyroid gland. Samples from 28 patients were frozen at -70ºC for subsequent tests, whereas samples from three patients were tested while surgery was being performed. IO-PTH was measured using the Elecsys immunochemiluminometric assay (Roche, Mannheim, Germany). The time necessary to perform the assay was 9 min. All samples had a second measurement taken by a conventional immunofluorimetric method. We considered as cured patients who presented normocalcemia in PHP and THP, and normal levels of PTH in SHP one month after surgery and who remained in this condition throughout the follow-up of 1 to 20 months. When rapid PTH assay was compared with a routine immunofluorimetric assay, excellent correlation was observed (r = 0.959, P < 0.0001). IO-PTH measurement showed a rapid average decline of 78.8% in PTH 10 min after adenoma resection in PHP and all patients were cured. SHP patients had an average IO-PTH decrease of 89% 30 min after total parathyroidectomy and cure was observed in 85.7%. THP showed an average IO-PTH decrease of 91.9%, and cure was obtained in 87.5% of patients. IO-PTH can be a useful tool that might improve the rate of successful treatment of PHP, SHP and THP.
Palavra-chave Parathyroid hormone
Intraoperative PTH measurement
Primary hyperparathyroidism
Secondary hyperparathyroidism
Tertiary hyperparathyroidism
Idioma Inglês
Data de publicação 2003-06-01
Publicado em Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 36, n. 6, p. 715-721, 2003.
ISSN 0100-879X (Sherpa/Romeo, fator de impacto)
Publicador Associação Brasileira de Divulgação Científica
Extensão 715-721
Fonte http://dx.doi.org/10.1590/S0100-879X2003000600006
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000183866400006
SciELO S0100-879X2003000600006 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/1753

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