Assessing the impact of low baseline parathyroid hormone levels on surgical treatment of primary hyperparathyroidism

Abstract

Patients with preoperative low baseline iPTH levels are over two times more likely to have multigland disease than patients with high baseline levels. Preoperative imaging in this group appears to be less likely to yield a solitary adenoma, even in the absence of multigland disease. IOPTH degradation kinetics is variable between groups, resulting in the possibility of inconsistent correlation with complete resection. These findings suggest that the current IOPTH guidelines, with reference to adequacy of resection, may need to be amended, especially for patients with low baseline iPTH levels. Laryngoscope, 2009.