med j west black sea Medical Journal of Western Black Sea 2822-4302 2587-0602 Zonguldak Bülent Ecevit Üniversitesi 10.29058/mjwbs.1656011 Endocrinology Endokrinoloji Primer hiperparatiroidizm sebebiyle cerrahi tedavi uygulanan hastalarda ameliyat sonrası normokalsemik yüksek parathormon sıklığı: Tek merkez deneyimi Postoperative frequency of normocalcemic elevated parathormone in patients surgically treated for primary hyperparathyroidism: A single-center experience https://orcid.org/0000-0002-0920-6895 Elbüken Gülşah Tekirdag Namik Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Tekirdag, Turkiye https://orcid.org/0000-0001-6558-6522 Bilen Ogün İrem Tekirdag Namik Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Tekirdag, Turkiye https://orcid.org/0000-0001-5230-5816 Öztürk Beyza Olcay Tekirdag Namik Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Tekirdag, Turkiye https://orcid.org/0000-0002-5503-5177 Ağgül Hünkar Tekirdag Namik Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Tekirdag, Turkiye https://orcid.org/0000-0001-5649-6699 Özkan-Gürdal Sibel Tekirdag Namik Kemal University Faculty of Medicine, Department of General Surgery, Tekirdag, Türkiye https://orcid.org/0000-0002-5998-4070 Tokuç Burcu Tekirdag Namik Kemal University Faculty of Medicine, Department of Medical Education, Tekirdag, Türkiye https://orcid.org/0000-0001-8084-848X Zuhur Sayid Shafi Tekirdag Namik Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Tekirdag, Turkiye 03 26 2026 Advanced Online Publication 03 13 2025 02 02 2026 Copyright © 2017, Batı Karadeniz Tıp Dergisi 2017 Batı Karadeniz Tıp Dergisi

Amaç: Primer hiperparatiroidi nedeniyle paratiroidektomi yapılan bazı hastalarda, serum kalsiyum düzeyleri normale dönmesine rağmen parathormon (PTH) düzeyleri yüksek kalabilir. Bu durum “postoperatif normokalsemik yüksek PTH” olarak tanımlanır. Bu çalışmada, primer hiperparatiroidi nedeniyle ameliyat edilen hastalarda postoperatif normokalsemik yüksek PTH sıklığı araştırılmıştır. Gereç ve Yöntemler: Çalışmada 127 hastanın ameliyat öncesi, ameliyat esnasındaki, erken postoperatif (ameliyattan sonraki gün ile taburculuk dahil ilk 7 gün) ve geç postoperatif (1., 3., 6. ve 12. aylar) laboratuvar değerleri geriye dönük olarak incelendi. Düzeltilmiş kalsiyum, serum albüminine göre hesaplandı. Bulgular: Postoperatif normokalsemik yüksek PTH ile uyumlu laboratuvar bulguları: 1. ayda %56, 3. ayda %44, 6. ayda %42.3, 12. ayda %31.9 olarak bulundu. Ortalama 44.0±27.2 ay (ortanca 36, min 15 – maks 144) takip edilen 91 hastanın tümünde serum kalsiyum düzeyleri normaldi. Son kontrolde hem serum kalsiyum hem PTH değeri bulunan hastalarda postoperatif normokalsemik yüksek PTH sıklığı %34.4 olarak saptandı. Sonuç: Postoperatif normokalsemik yüksek PTH sıklığı, kullanılan kriterlere ve hasta serilerine göre değişebilir. Altta yatan sekonder hiperparatiroidinin katkısı araştırılmalı ve yönetilmelidir. Ayrıca bu bulgunun primer hiperparatiroidi nüksünü gösterebileceği unutulmamalıdır. Hastaların düzenli takibi gereklidir.

Aim: After parathyroidectomy, parathormone levels may remain elevated despite normalization of serum calcium levels in some patients, which is known as “postoperative normocalcemic elevated parathormone”. In this study, we aimed to determine postoperative normocalcemic elevated parathormone frequency in patients undergoing parathyroidectomy due to primary hyperparathyroidism through a retrospective review.Material and Methods: Preoperative, intraoperative, early postoperative (maximum 7-days, starting from the next day of surgery until discharge) and late postoperative (months 1, 3, 6 and 12) laboratory tests of the 127 patients were reviewed retrospectively. Corrected calcium levels were obtained using serum albumin levels.Results: Laboratory values consistent with postoperative normocalcemic elevated parathormone were identified in 56%, 44%, 42.3% and 31.9% of the patients at 1, 3, 6 and 12 months postoperatively. There are missing data in the 127 patients who underwent surgery because some patients did not attend their follow-up visits or were followed up in other centers. Serum calcium values were available and within normal range for all 91 patients followed for a mean duration of 44.0±27.2 months (median= 36, min= 15, max=144). The frequency of postoperative normocalcemic elevated parathormone was 34.4% among patients with serum calcium and PTH measurements available from the last visit. Conclusion: The prevalence of postoperative normocalcemic elevated parathormone varies among different patient series depending on the criteria used. Whether the underlying secondary hyperparathyroidism contributes to postoperative normocalcemic elevated parathormone should be investigated and managed appropriately. Considering that postoperative normocalcemic elevated parathormone may also represent primary hyperparathyroidism recurrence, regular follow-up is required for patients.

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