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Open Med (Wars). 2019 Jun 7;14:437-442. doi: 10.1515/med-2019-0047. eCollection 2019.

Correlation between iPTH Levels on the First Postoperative Day After Total Thyroidectomy and Permanent Hypoparathyroidism: Our Experience.

Author information

1
Department of Surgical Sciences, University of Cagliari, "Policlinico Universitario Duilio Casula", 09042, Monserrato (CA), Italy.
2
Department of Medical Sciences, University of Cagliari, Endocrinology Unit, "Policlinico Universitario Duilio Casula", 09042, Monserrato (CA), Italy.
3
Department of General Surgery, General and Endocrine Surgical Unit, Second University of Naples, 80131, Naples, Italy.

Abstract

Permanent hypoparathyroidism is the most common long-term complication after thyroidectomy. We evaluated whether iPTH concentrations on the first postoperative day may be a good predictor of this complication. Patients undergoing thyroidectomy in our Unit between January 2017 and February 2018 who developed postsurgical hypoparathyroidism were analysed. According to iPTH values on the first postoperative day and on the basis of the detection threshold of the iPTH test used, patients were divided into 2 groups: Group A (iPTH < 6.3 pg/mL, undetectable), Group B (iPTH ≥ 6.3 pg/mL). Seventy-five patients were included in this study: 64 in Group A and 11 in Group B. Permanent hypoparathyroidism occurred in 14 (21.88%) patients in Group A, while none developed this complication in Group B. When iPTH was < 6.3 pg/mL, the sensitivity for the prediction of permanent hypoparathyroidism was 100%, the specificity was 18.03%, the positive predictive value was 21.88% and the negative predictive value was 100%. No patient with iPTH ≥ 6.3 pg/mL on the first postoperative day developed permanent hypoparathyroidism. On the other hand, iPTH concentrations < 6.3 pg/mL have not proved to be a strong predictor of this condition. However, this cut-off value can be useful to identify patients at risk of developing this complication.

KEYWORDS:

Intact parathyroid hormone; Permanent hypoparathyroidism; Total thyroidectomy; Undetectable iPTH

Conflict of interest statement

Conflict of interest: Authors state no conflict of interest.

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