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Journals / Batı Karadeniz Tıp Dergisi / 2026 / Cilt: 10 Sayı: 1

Postoperative frequency of normocalcemic elevated parathormone in patients surgically treated for primary hyperparathyroidism: A single-center experience

Primer hiperparatiroidizm sebebiyle cerrahi tedavi uygulanan hastalarda ameliyat sonrası normokalsemik yüksek parathormon sıklığı: Tek merkez deneyimi

Gülşah Elbüken(Department of Internal Medicine, Tekirdağ Namık Kemal University Faculty of Medicine, Division of Endocrinology and Metabolism, Tekirdağ, Türkiye)0000-0002-0920-6895
Ogün İrem Bilen(Department of Internal Medicine, Tekirdağ Namık Kemal University Faculty of Medicine, Division of Endocrinology and Metabolism, Tekirdağ, Türkiye)0000-0001-6558-6522
Beyza Olcay Öztürk(Department of Internal Medicine, Tekirdağ Namık Kemal University Faculty of Medicine, Division of Endocrinology and Metabolism, Tekirdağ, Türkiye)0000-0001-5230-5816
Hünkar Ağgül(Department of Internal Medicine, Tekirdağ Namık Kemal University Faculty of Medicine, Division of Endocrinology and Metabolism, Tekirdağ, Türkiye)0000-0002-5503-5177
Sibel Özkan-Gürdal(Department of General Surgery, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdağ, Türkiye)0000-0001-5649-6699
Burcu Tokuç(Department of Medical Education, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdağ, Türkiye)0000-0002-5998-4070
Sayid Shafi Zuhur(Department of Internal Medicine, Tekirdağ Namık Kemal University Faculty of Medicine, Division of Endocrinology and Metabolism, Tekirdağ, Türkiye)0000-0001-8084-848X
Pages
106–115
Publication Date
2026-03-26
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Considering that postoperative normocalcemic elevated parathormone may also represent primary hyperparathyroidism recurrence, regular follow-up is required for patients.

📌 3 Key Takeaways

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Objective & Hypothesis: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”.
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Key Findings & Data: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.
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Conclusion & Impact:Considering that postoperative normocalcemic elevated parathormone may also represent primary hyperparathyroidism recurrence, regular follow-up is required for patients.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Parathormon · paratiroidektomi · postoperatif normokalsemik yüksek PTH

Abstract

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.

Özet

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.

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Cite This Article

Elbüken, G., Bilen, O. İ., Öztürk, B. O., Ağgül, H., Özkan-Gürdal, S., Tokuç, B., Zuhur, S. S. (2026). Postoperative frequency of normocalcemic elevated parathormone in patients surgically treated for primary hyperparathyroidism: A single-center experience. Batı Karadeniz Tıp Dergisi, Cilt: 10 Sayı: 1, 106–115. https://doi.org/10.29058/mjwbs.1656011

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