RAPID PEROPERATIVE ASSAY OF INTACT PARATH ORMONE IN PRIMARY HYPERPARATHYROIDISM - EVALUATION AND COMPARISON WITH THE LONG METHOD

Objectives: To evaluate the efficacy of rapid peroperative assay of pa rathormone in patients with primary hyperparathyroidism compared with the longer standard assay. Methods: Primary hyperthyroidism was diagno sed in 10 patients (8 males, 2 females, mean age 55 +/- 8.6 years, ran ge 36-99) (preoperative tests: serum calcium 290 +/- 8.9 nmol/l, range 274-311; intact parathormone 137 +/- 31.3 pg/ml, range 87-250). First intention cervicotomy was performed. Blood samples were drawn at indu ction of anaesthesia, at palpation of the adenoma, and 15, 30 and 45 m inutes after ablation. Each sample was assayed with a rapid radioimmun oassay and the longer standard laboratory methods. Results: There was a good correlation between the two assay methods. In the 9 patients wi th a solitary adenoma, serum levels of parathormone were normalized 15 (n=8) or 30 minutes (n=1) after resection. Conclusion: Rapid radioimm unoassay is a reliable method for evaluating serum parathormone level peroperatively. Although financial implications may limit its use, thi s rapid assay is clearly indicated for patients in poor clinical condi tion undergoing first intention surgery and in those undergoing a seco nd cervicotomy.