Near-patient parathyroid hormone immunoassay for intraoperative monitoringin parathyroid surgery

Appropriate parathyroidectomy by skilled surgeons is the procedure of choic e to treat hyperparathyroidism, The operation requires the surgeon to find and remove the correct amount of abnormal parathyroid tissue. The number an d location of parathyroid glands are quite variable, although four glands a re found in the majority of the population. Locating parathyroid tissue is particularly difficult in re-operative cases due to the disturbed tissue pl ane and the increased likelihood that the diseased gland or glands may be i n an ectopic site (thymus, mediastinum), Currently, there are commercial pa rathyroid hormone (PTH) measurement kits available, but use of such kits si gnificantly increases the cost of surgery. We developed a rapid PTH assay b y using in-house antibodies. In this article, we report our cumulative labo ratory experience in the development of a rapid PTH assay for intraoperativ e monitoring and further evaluate its surgical value, We hope our experienc e can be used by others to develop their own "in-house" rapid assay and par ticularly by industry to develop cost effective rapid PTH assays. Presently , the cost of commercial kits prevents their widespread use.