ArticleInternational journal of endocrinology2021
Evaluation of Wisconsin and CaPTHUS Indices Usefulness for Predicting Monoglandular and Multiglandular Disease in Patients with Primary Hyperparathyroidism through the Analysis of a Single-Center Experience.
Article in International journal of endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 16 citations in OpenAlex.
- Serum Biomarker-Based Diagnostic Tools for Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis with Implications for Primary Care.Healthcare (Basel, Switzerland) · 2026Review
- Parathyroidectomy and the use of ioPTH. A survey of the United Italian Society of Endocrine Surgery (SIUEC).Updates in surgery · 2026Article
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- Article
- Management of surgical diseases of Primary Hyperparathyroidism: indications of the United Italian Society of Endocrine Surgery (SIUEC).Updates in surgery · 2024Review
- Primary hyperparathyroidism: predictors of sporadic multi-gland disease.Endocrine connections · 2024Review
- A contemporary analysis of the pre- and intraoperative recognition of multigland parathyroid disease.Langenbeck's archives of surgery · 2023Review
- Comparison of biochemical markers and technetium 99m methoxyisobutylisonitrile imaging in primary and secondary hyperparathyroidism.Frontiers in endocrinology · 2023Article
- Management and surgical treatment of parathyroid carcinoma: a 6-year experience of a single centre of endocrine surgery unit.Frontiers in endocrinology · 2023Observational
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- Contribution of intraoperative parathyroid hormone monitoring to the surgical success in minimal invasive parathyroidectomy.Frontiers in surgery · 2022Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe main challenge for treating primary hyperparathyroidism (PHPT) is to understand if it is caused by a single adenoma (80-85% of the cases) or by a multiglandular disease (15-20%), both preoperatively and intraoperatively. For this reason, some preoperative scores were proposed in the literature, to perform focused parathyroidectomy, avoiding intraoperative parathormone assay (ioPTH). The most known are the CaPTHUS test and the Wisconsin index. We applied them to our experience.
methodsA retrospective cohort study on 462 patients referred for parathyroidectomy to Thyroid and Parathyroid Unit at Santi Paolo e Carlo Hospital, Milan, Italy, from 2011 to 2021. Only patients affected with benign PHPT and neck ultrasound performed at our institution were included. Both patients for whom preoperative imaging agreed with the localization of a single diseased parathyroid and those with only ultrasound or scintigraphy positive for parathyroid localization underwent Mini-Invasive Video-assisted parathyroidectomy. In all cases, ioPTH assay was performed. The conversion to bilateral neck exploration was decided based on the drop in ioPTH. CaPTHUS score and the Wisconsin index (Win) were applied to the series. CaPTHUS score ≥3 and Win index >1600, according to the original studies of the literature, were considered at high probability of monoglandular disease. Outcomes in these two groups were examined.
results236 patients were eligible for the study. The pathology resulted in multiglandular disease in 24 patients (10.2%). Among these, 18 (75.0%) obtained a CaPTHUS score ≥3, and 20 (83.3%) had a Win index>1600. Intraoperative PTH allowed to identify multiglandular disease in 16 of 18 cases with CaPTHUS ≥3 and in 18 of 20 cases with win >1600, who could have been lost, based only on the results of these 2 tests.
conclusionBased on our experience, CaPTHUS test and Wisconsin index were not so useful in predicting multiglandular disease as ioPTH.
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