Quick parathormone assay in the surgical management of hyperparathyroidism

Background: Among the various new technologies in the field of parathyroid surgery is intraoperative quick parathormone measurements. Objectives: To evaluate the contribution of QPTH measurements during parathyroidectomy to the achievement of higher success rates. Methods: QPTH assay using Immulite Turbo Intact PTH was measured in 32 patients undergoing parathyroidectomy: 30 for primary and 2 for secondary hyperparathyroidism. QPTH levels were measured at time 0 minutes (before incision) and at 10,20, and 30 minutes after excision of the hyperfunctioning gland. Only a drop of 60% or more from the 0′ level was considered to be a positive result. Results: The mean QPTH level at time 0′ for PHPT patients was 38.12 ± 25.15 pmol/L (range 9.1-118 pmol/L). At 10 minutes post-excision of the hyperfunctioning gland (or glands), QPTH dropped by a mean of 73.80% to 9.89 ± 18.78 pmol/L. Conclusions: Intraoperative QPTH level measurement is helpful in parathyroid surgery. A drop of 60% or more from 0′ level indicates a successful procedure, and further exploration should be avoided.