Abstract
In 1988, at Massachusetts General Hospital, Nussbaum et al. modified the original immunoradiometric assay by increasing the temperature of incubation and employing a kinetic enhancer; the above changes decreased the turnover time to approximately 15 minutes [1, 2]. In this initial report, the first use of parathyroid hormone (PTH) monitoring during parathyroidectomy (PTx) was described, although the patients in this series underwent bilateral neck exploration and PTH was measured postoperatively. Although the reporting of this experience appeared to be of clinical interest, it was not readily accepted as an alternative to the existing practice of highly successful conventional bilateral neck exploration. In 1990, Chapuis et al. from Paris reported their series of 13 patients in whom the intact PTH (iPTH) dropped below 70% within 20 minutes after PTx, by using the immunoradiometric assay for intraoperative iPTH measurement [3].
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Nussbaum SR, Zahradnik R, Lavigne J et al (1987) Highly sensitive two-site immunoradiometric assay for parathyrin and its clinical utility in evaluating patients with hypercalcemia. Clin Chem 33:1364–1367
Nussbaum SR, Thompson AR, Hutcheson KA et al (1988) Intraoperative measurement of parathyroid hormone in the surgical management of hyperparathyroidism. Surgery 104:1121–1127
Chapuis Y, Fulla Y, Icard P et al (1990) Peroperative assay of active parathormone 1-84 in surgery of primary hyperparathyroidism. Presse Med 19:1461–1462
Irvin GL 3rd, Dembrow VD, Prudhomme DL (1991) Operative monitoring of parathyroid gland hyperfunction. Am J Surg 162:299–302
Boggs JE, Irvin GL 3rd, Molinari AS et al (1996) Intraoperative parathyroid hormone monitoring as an adjunct to parathyroidectomy. Surgery 120:954–958
Irvin GL 3rd, Carneiro DM, Solorzano CC (2004) Progress in the operative management of sporadic primary hyperparathyroidism over 34 years. Ann Surg 239:704–708 (discussion 708-711, 713)
Grant CS, Thompson G, Farley D et al (2005) Primary hyperparathyroidism surgical management since the introduction of minimally invasive parathyroidectomy: Mayo Clinic experience. Arch Surg 140:472–478 (discussion 478-479)
Westerdahl J, Bergenfelz A (2004) Sestamibi scan-directed parathyroid surgery: potentially high failure rate without measurement of intraoperative parathyroid hormone. World J Surg 28:1132–1138
Chen H, Pruhs Z, Starling JR et al (2005) Intraoperative parathyroid hormone testing improves cure rates in patients undergoing minimally invasive parathyroidectomy. Surgery 138:583–587 (discussion 587-590)
Cayo AK, Sippel RS, Schaefer S et al (2009) Utility of intraoperative PTH for primary hyperparathyroidism due to multigland disease. Ann Surg Oncol 16:3450–3354
Hughes DT, Miller BS, Doherty GM et al (2011) Intraoperative parathyroid hormone monitoring in patients with recognized multiglandular primary hyperparathyroidism. World J Surg 35:336–341
Mengozzi G, Rossato D, Bertello C et al (2007) Rapid cortisol assay during adrenal vein sampling in patients with primary aldosteronism. Clin Chem 53:1968–1971
Carneiro-Pla D (2011) Contemporary and practical uses of intraoperative parathyroid hormone monitoring. Endocr Pract 17(Suppl 1):44–53
Carter AB, Howanitz PJ (2003) Intraoperative testing for parathyroid hormone a comprehensive review of the use of the assay and the relevant literature. Arch Pathol Lab Med 127:1424–1442
Mengozzi G, Baldi C, Aimo G et al (2001) Optimizing efficacy of quick parathyroid hormone determination in the operating theater. Int J Biol Markers 15:153–160
Gasparri G, Camandona M, Bertoldo U et al (2009) The usefulness of preoperative dual-phase 99mTc MIBI-scintigraphy and IO-PTH assay in the treatment of secondary and tertiary hyperparathyroidism. Ann Surg 250:868–871
Barczyński M, Gołkowski F, Nawrot I (2015) The current status of intraoperative iPTH assay in surgery for primary hyperparathyroidism. Gland Surgery 4:36–43
Barczyński M, Konturek A, Hubalewska-Dydejczyk A et al (2009) Evaluation of Halle, Miami, Rome, and Vienna intraoperative iPTH assay criteria in guiding minimally invasive parathyroidectomy. Langenbecks Arch Surg 394:843–849
Bergenfelz AO, Hellman P, Harrison B et al (2009) Positional statement of the European Society of Endocrine Surgeons (ESES) on modern techniques in pHPT surgery. Langenbecks Arch Surg 394:761–764
Morris LF, Zanocco K, Ituarte PH et al (2010) The value of intraoperative parathyroid hormone monitoring in localized primary hyperparathyroidism: a cost analysis. Ann Surg Oncol 17:679–685
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer-Verlag Italia
About this chapter
Cite this chapter
Mengozzi, G. (2016). Clinical Use of the Parathyroid Hormone Assay. In: Gasparri, G., Palestini, N., Camandona, M. (eds) Primary, Secondary and Tertiary Hyperparathyroidism. Updates in Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5758-6_4
Download citation
DOI: https://doi.org/10.1007/978-88-470-5758-6_4
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-5757-9
Online ISBN: 978-88-470-5758-6
eBook Packages: MedicineMedicine (R0)