caa a22 4500 445334541 CHVBK 20180317142749.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1245/s10434-011-1744-x doi (NATIONALLICENCE)springer-10.1245/s10434-011-1744-x Normal PTH Levels in Primary Hyperparathyroidism: Still the Same Disease? [Elektronische Daten] [Amanda Amin, Tracy Wang, Thomas Wade, Tina Yen] Purpose: Previous studies have suggested that primary hyperparathyroidism (pHPT) with only normal parathyroid hormone (PTH) levels is a milder, less symptomatic form of pHPT. This study investigates symptoms, laboratory values, imaging, and outcomes of sporadic pHPT patients with normal PTH values. Methods: We reviewed our prospectively collected database of 861 patients with sporadic pHPT who underwent parathyroidectomy between December 1999 and June 2010. Patients with only normal PTH values for 6months before surgery were compared to a randomized control group of sporadic pHPT patients with elevated PTH, matched 1:2 for age and gender. Results: Fifty-eight (7%) patients had only normal PTH values within 6months of surgery. The mean PTH was 55.1pg/ml in the normal PTH group and 151.3pg/ml in the control group (n=116). There was no difference in preoperative calcium values, subjective symptoms, bone health, or the frequency of single-gland disease (SGD; 88% vs. 91%) between the two groups, but the normal PTH group had higher preoperative vitamin D values (30.8 vs. 21.4ng/ml; P<0.001), smaller adenomas (405 vs. 978mg, P<0.001), and more frequently underwent bilateral neck exploration (57% vs. 49%). There was a trend toward lower sensitivity of preoperative imaging in the normal PTH group. Conclusions: Patients with pHPT and either elevated or normal PTH levels present with similar symptoms and calcium levels. The majority of patients with normal PTH have SGD, although adenomas are smaller. This may explain why patients with normal PTH values have less sensitive imaging and more frequently require four-gland exploration. Society of Surgical Oncology, 2011 Amin Amanda Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut Wang Tracy Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut Wade Thomas Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut Yen Tina Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3437-3442 1068-9265 18:12<3437 2011 18 10434 https://doi.org/10.1245/s10434-011-1744-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1744-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Amin Amanda Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Wang Tracy Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Wade Thomas Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Yen Tina Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3437-3442 1068-9265 18:12<3437 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer