Demographic profile and clinical outcome of patients diagnosed with parathyroid adenoma after one year of parathyroidectomy - A Makati Medical Center experience
- Author:
Thelma Dimalanta-Crisostomo
;
JardinE M Golangco
- Publication Type:Journal Article
- From:
Philippine Journal of Internal Medicine
2011;49(3):142-150
- CountryPhilippines
- Language:English
-
Abstract:
Background: The paper aims to present the clinical profile and treatment outcomes of both asymptomatic and symptomatic hyperparathyroid patients in our institution. Methodology: This is a retrospective, descriptive study, which involved reviewing histopathology records from 2004 to 2008. Collected data were tabulated. Statistical means and percentages were used to present the results. A paired t test was used to compare continous variables. Results: A total of 12 patients were diagnosed with parathyroid adenoma on final histopathological diagnosis. Ten out of 12 patients underwent unilateral cervical parathyroidectomy, while two patients had incidental findings of parathyroid adenoma after total thyroidectomy. The difference between pre-operative ionized calcium levels of asymptomatic hyperparathyroid patients compared with symptomatic patients were not statistically significant, 1.88 mmol/L ± 0.43 mmol/L vs. 1.80 mmol/L ± 0.29 mmol/L, respectively. All asymptomatic patients satisfied one or more of the updated National Institute of Health guidelines for parathyroidectomy of asymptomatic hyperparathyroidism. Levels of intact PTH postoperatively showed decrease by more than 50% from the pre-operative values from 693.337 pg/mL (± 744.532 pg/mL) to 124.016 pg/mL (± 73.921 pg/ mL) after parathyroidectomy, showing 100% cure rate. Almost 50% of the patients suffered from hypocalcemic symptoms (mean calcium level 1.08 mmol/L) by the second to third post-operative day. Normocalcemia was achieved within one year post-parathyroidectomy. Conclusion: Our study showed that it is prudent to request for repeat serum ionized calcium during the first four days post-operatively, where most of the serum ionized calcium levels of our patients were noted to decrease. Furthermore, we should start our patients with calcium supplementation post-parathyroidectomy, even if initial serum ionized calcium are normal.
