Document Detail


Accuracy of selective venous sampling for intact parathyroid hormone in difficult patients with recurrent or persistent hyperparathyroidism.
MedLine Citation:
PMID:  12490840     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Preoperative noninvasive localization studies of the neck and mediastinum are beneficial before reoperation. However, the role of selective venous sampling (SVS) for parathyroid hormone (PTH) in reoperative parathyroid surgery has never been clearly defined. The purpose of this study was to evaluate the accuracy of SVS when applied selectively to the subset of patients with indeterminate noninvasive localization studies. METHODS: Between January 1990 and December 2001, 64 of 235 (27%) patients with persistent or recurrent hyperparathyroidism were considered candidates for SVS in addition to noninvasive localization studies. Accuracy of SVS for PTH was retrospectively evaluated. RESULTS: Successful surgical treatment was achieved in 86% of these patients. SVS for PTH yielded true-positive results in 75% of patients and was not useful for the surgeon in 17% (completely false-positive in 12% and indeterminate in 5%). In 2% of patients, SVS identified successfully 1 gland but failed to locate another abnormal gland. In 6% of patients, the location of the abnormal parathyroid tissue remained unknown, and the patients have persistent hyperparathyroidism. CONCLUSIONS: We showed that SVS is clinically useful in patients with persistent or recurrent hyperparathyroidism when the noninvasive localization studies do not clearly localize the abnormal parathyroid glands.
Authors:
Julia J Jones; Laurent Brunaud; Christopher F Dowd; Quan-Yang Duh; Eugene Morita; Orlo H Clark
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgery     Volume:  132     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-19     Completed Date:  2003-01-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  944-50; discussion 950-1     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology (Neuroradiology), University of California San Francisco/Mount Zion Medical Center, 1600 Divisadero Street, Room 437, San Francisco, CA 94143-1674, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
False Positive Reactions
Female
Humans
Hyperparathyroidism / blood*,  diagnosis*
Male
Middle Aged
Parathyroid Hormone / analysis*,  blood*
Recurrence
Reproducibility of Results
Retrospective Studies
Veins
Chemical
Reg. No./Substance:
0/Parathyroid Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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