Prediction and diagnosis of sporadic multiglandular parathyroid disease by the method of mathematical analysis

Abstract

Background. Sporadic multiglandular parathyroid disease remains an unresolved problem in endocrine surgery. This is due to the complexity of clinical and laboratory prediction, insufficient sensitivity of imaging methods and intraoperative monitoring of intact parathyroid hormone.Аim is to develop a predictive scale for multiple lesions of the parathyroid glands in primary hyperparathyroidism.Materials and methods. A single-center prospective study was conducted, including 126 cases of surgical treatment of primary hyperparathyroidism (2019-2021). The main endpoint of the study was to develop a scale for predicting multiple PTG lesions in PHPT using the method of mathematical analysis.Results. The developed scale includes determination of serum levels of albumin-corrected calcium and parathyroid hormone, glomerular filtration rate (GFR), measurement of parathyroid glands parameters according to ultrasound and/or scintigraphy and assessment of the consistency of these results and determination of the value of the coefficient KIB. The results are evaluated in points. If the total score is less than 2, multiglandular parathyroid disease is diagnosed, equal to or more than 2 - one gland.Conclusion. Mathematical prediction of sporadic multiglandular parathyroid disease allows clarifying the preoperative diagnosis and planning the scope of surgical treatment.

Keywords

• множественное поражение околощитовидных желез, первичный гиперпаратиреоз, диагностика, прогнозирование.