{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T05:48:38Z","timestamp":1794030518448,"version":"4.8.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Intraoperative parathyroid hormone (IOPTH) monitoring is a critical surgical adjunct for determining the extent of surgery for primary hyperparathyroidism (PHPT), with reported false-positive and false-negative rates of up to 10%. Surgeons must understand the parathyroid hormone (PTH) dynamics and select the appropriate IOPTH protocol and interpretation criteria for curative surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We present the case of a 64-year-old woman with a large cystic parathyroid tumor and PHPT who experienced a significant delay in IOPTH decrease but was cured without additional surgery. The patient\u2019s basal intact PTH was 96.2\u00a0pg\/mL, which decreased to 93.3\u00a0pg\/mL at 25\u00a0min and 72.4\u00a0pg\/mL at 55\u00a0min after removal of the parathyroid tumor. In an attempt to elucidate its pathophysiology, 1\u201384 PTH levels were measured in stored serum. These results can also be attributed to the relatively low basal PTH levels, intact PTH spike, and high ratio of large carboxyl-terminal PTH fragments present. The patient had normal intact PTH and calcium levels at the 9-month postoperative visit.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>As detailed reports on these phenomena are scarce, we discuss the causes of false-negative IOPTH results in terms of PTH production, secretion, metabolism, and differences in measurement methods to avoid unnecessary surgery.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-024-01903-z","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T07:01:56Z","timestamp":1714028516000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Intraoperative parathyroid hormone measurement pitfalls: parathyroid hormone spikes with carboxyl-terminal parathyroid hormone fragments in primary hyperparathyroidism\u2014a case report"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0805-8886","authenticated-orcid":false,"given":"Hiroyuki","family":"Yamashita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisakazu","family":"Shindo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouichi","family":"Yoshimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Mori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seigo","family":"Tachibana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"1903_CR1","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.otohns.2004.10.005","volume":"132","author":"JM Ruda","year":"2005","unstructured":"Ruda JM, Hollenbeak CS, Stack BC Jr. A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003. Otolaryngol Head Neck Surg. 2005;132:359\u201372.","journal-title":"Otolaryngol Head Neck Surg"},{"key":"1903_CR2","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1067\/msy.2001.118376","volume":"130","author":"G Agarwal","year":"2001","unstructured":"Agarwal G, Barakate MS, Robinson B, Wilkinson M, Barraclough B, Reeve TS, et al. Intraoperative quick parathyroid hormone versus same-day parathyroid hormone testing for minimally invasive parathyroidectomy: a cost-effectiveness study. Surgery. 2001;130:963\u201370.","journal-title":"Surgery"},{"key":"1903_CR3","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1001\/archsurg.136.8.945","volume":"136","author":"GP Yang","year":"2001","unstructured":"Yang GP, Levine S, Weigel RJ. A spike in parathyroid hormone during neck exploration may cause a false-negative intraoperative assay result. 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