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Abstract
Background. Primary hyperparathyroidism (pHPT) is associated with a defective regulation of the
secretion of parathyroid hormone (PTH). Thus in pHPT, higher than normal calcium concentrations
are required to inhibit PTH release. However, it is not known if this defective regulation
is normalized by removal of the parathyroid adenoma (i.e., whether the regulation
of PTH secretion is normal in the remaining glands). In this study we therefore investigated
the PTH secretion in patients operated on for parathyroid adenoma 1 year after operation.
Methods. Na2 ethylenediamine tetraacetic acid and CaCI2 were infused at constant rates in six patients operated on for parathyroid adenoma
and six healthy individuals. Serum levels of intact PTH and ionized calcium were determined
during the infusions.
Results. No significant differences between the two groups were found in baseline levels of
serum ionized calcium and PTH. Furthermore, no significant differences between patients
and control subjects were found in the maximum serum PTH levels during the hypocalcemic
infusion of ethylenediamine tetraacetic acid or in the minimum serum PTH levels during
the calcium infusion. In contrast, the set point (the calcium concentration required
for half-maximal inhibition of PTH secretion) was significantly lower in the patients
(1.20 ± 0.01 mmol/L) compared with control subjects (1.22 ± 0.01 mmol/L; p < 0.05).
Conclusions. We conclude that the elevation of set point in patients with parathyroid adenoma
is corrected by successful operation. This suggests a monoclonal origin of parathyroid
adenomas.
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Article info
Publication history
Accepted:
March 23,
1992
Footnotes
☆Supported by the Medical Faculty, Lund University, Lund, Sweden.
Identification
Copyright
© 1993 Published by Elsevier Inc.
