caa a22 4500 475803639 CHVBK 20180406123744.0 cr unu---uuuuu 170329e20001101xx s 000 0 eng 10.1007/s002680010219 doi (NATIONALLICENCE)springer-10.1007/s002680010219 Postoperative Elevated Serum Levels of Intact Parathyroid Hormone after Surgery for Parathyroid Adenoma: Sign of Bone Remineralization and Decreased Calcium Absorption [Elektronische Daten] [Johan Westerdahl, Stig Valdemarsson, Pia Lindblom, Anders Bergenfelz] Increased levels of intact parathyroid hormone (PTH) have been documented after surgery for primary hyperparathyroidism (pHPT) despite normocalcemia. The pathogenesis remains to be elucidated. Seventeen consecutive patients operated on for solitary parathyroid adenoma were investigated before and at 8 weeks and 1 year after surgery with serum levels of intact PTH, biochemical variables known to reflect PTH activity, and bone mineral content (BMC). In addition, an oral calcium loading test was performed 8 weeks after the operation. All patients had low or normal serum calcium levels during follow-up. Eight weeks after operation six patients (35%) had an increased serum PTH level. These patients (group I) preoperatively had higher serum levels of PTH and alkaline phosphatase than patients with normal PTH levels (group II). They also had lower BMC and larger parathyroid adenomas. They did not differ in renal function. At 8 weeks after operation group I showed higher mean serum levels of osteocalcin and propeptide of type I procollagen but lower urinary calcium excretion. In contrast to patients in group II, they also showed a lower calciuric response and a trend to a lower calcemic response during the oral calcium load. The two groups showed similar parathyroid sensitivity for calcium. Patients in group I demonstrated a significant increase in BMC the first year after the operation. Increased serum PTH 8 weeks after surgery for sporadic parathyroid adenoma was not due to persistent pHPT or impaired renal function. Instead, the results imply there is diminished calcium absorption and increased bone turnover with cortical bone remineralization. Société Internationale de Chirurgie, 2000 Westerdahl Johan Department of Surgery, Lund University Hospital, S-221 85 Lund, Sweden, SE aut Valdemarsson Stig Department of Internal Medicine, Lund University Hospital, S-221 85 Lund, Sweden, SE aut Lindblom Pia Department of Surgery, Lund University Hospital, S-221 85 Lund, Sweden, SE aut Bergenfelz Anders Department of Surgery, Lund University Hospital, S-221 85 Lund, Sweden, SE aut World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1323-1329 0364-2313 24:11<1323 2000 24 268 https://doi.org/10.1007/s002680010219 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010219 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Westerdahl Johan Department of Surgery, Lund University Hospital, S-221 85 Lund, Sweden, SE aut NATIONALLICENCE 700 1- Valdemarsson Stig Department of Internal Medicine, Lund University Hospital, S-221 85 Lund, Sweden, SE aut NATIONALLICENCE 700 1- Lindblom Pia Department of Surgery, Lund University Hospital, S-221 85 Lund, Sweden, SE aut NATIONALLICENCE 700 1- Bergenfelz Anders Department of Surgery, Lund University Hospital, S-221 85 Lund, Sweden, SE aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1323-1329 0364-2313 24:11<1323 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer