Parathyroid Hormone PTH Before Surgery Was 1000 Pg/ml And 1

Posted on Mon, 8 Jul 2019

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Mon, 8 Jul 2019 Answered on

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Question : Parathyroid hormone PTH before surgery was 1000 pg/ml and 1 month after surgery 3035 pg/ml. During the surgery most of the parathyroid glands were removed. It was expected that after surgery the PTH will drop, but hasn’t. The patient is suffering from lower kidney function. The creatinine is 319umol/L. What’s the next step in this situation

Answered by Dr. Mirjeta Guni (31 hours later)

Brief Answer:
About secondary hyperparathyroidism:

Detailed Answer:
Hello and thank you for asking!
Secondary hyperparathyroidism caused by impaired renal function consists usually in hyperplasia of the 4 parathyroid glands and the intervention consists in removing 3+ 3/4 of the remaining 4th gland. The remaining 1/4 is implanted under the skin so it can be removed easily if PTh persists high after intervention.
In this case a parathyroid scintiscan with Sesta MiBi is performed to exclude an ectopic parathyroid gland and if it is excluded a re-intervention is recommended to remove the remaining gland.
Hope the information will help.
Best wishes,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Vaishalee Punj