Simplified intraoperative parathormone assay for primary hyperparathyroidism in a resource-limited setting.

Abstract

Background: The optimum threshold of IOPTH decay remains a debate and numerous criteria have been described. In this study, we utilize a single-sample IOPTH taken 10min postexcision. Materials & methods: This 4-year query of a prospectively maintained database included primary hyperparathyroidism patients with pre-operative PTH done 1week prior to surgery, and a 10-min post excision IOPTH value. Optimal cut-off for PTH and sensitivity/specificity were calculated. Results:A total of93 patients had single-gland disease, of whom79 (84.9%) were symptomatic. The 10-minpost excision assay sensitivity in single-gland disease was 97.8% (50% fall), 95% (60% fall) and 83.9% (70% fall). Conclusion: A postexcision single-shot IOPTH assay with a 50% fall offers a sensitivity of 97.8% in patients of primary hyperparathyroidism with single-gland benign disease.