Navegando por Palavras-chave "hormônio parathyroid"

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    Dosagem do paratormônio: predizendo o risco de hipocalcemia sintomática após tiroidectomia total
    (Universidade Federal de São Paulo (UNIFESP), 2014-05-28) Vanderlei, Felipe Augusto Brasileiro [UNIFESP]; Abrahão, Marcio [UNIFESP] ; Universidade Federal de São Paulo (UNIFESP)
    Hypocalcemia is the most frequent complication after total thyroidectomy. We developed a method, using peri-operative parathyroid hormone (PTH) measure, which can identify patients with increased risk of developing symptoms of hypocalcemia. The purpose of this study is to validate our method evaluating the development of hypocalcemia symptoms after total thyroidectomy in patients treated or not with calcium and vitamin D based on the PTH value measured one hour after the surgery. Methods: Two hundreds ninety eight total thyroidectomy patients with or without central neck dissection were evaluated prospectively. PTH was measures one hour after the surgery (PTH1). If the value of PTH1 ? 12.1 pg/mL the patient was observed, if PTH1 < 12,1 pg/mL the patient was treated with calcium and vitamin D supplementation. All the patients were evaluated for symptoms of hypocalcemia. Results: One hundred ninety six patients had PTH1 ? 12.1 pg/mL and among them 183 (94,4%) had no symptoms. Our test managed right all but eleven patients (96,3%). None of these eleven patients had severe symptoms nor needed further hospitalization demonstrating the security of the test. Our rate of transient hypocalcemia among the patients studied was 31.5% and 6.5% for persistent hypocalcemia. The value of PTH1 ? 9.5 pg/mL had a sensitivity of 78% and specificity of 100% for the non-development of persistent hypoparathyroidism. Conclusion: PTH measured one hour after surgery is safe, reliable and can successfully identify patients most likely to develop symptoms of hypocalcemia after total thyroidectomy.