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Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy

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Effect of hyperparathyroidism on coagulation: a global assessment by modified rotation thromboelastogram (ROTEM)

Göknur Yorulmaz¹, Ahmet Toygar Kalkan¹, Aysen Akalin¹

¹Department of Endocrinology and Metabolism, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey

Turkish Journal of Medical Sciences

|May 6, 2021

Summary

Primary hyperparathyroidism (PHPT) is linked to a hypocoagulable state, as shown by prolonged clotting times in thromboelastography. This suggests altered hemostasis in PHPT patients, though its impact on cardiovascular mortality remains unclear.

Keywords:

ROTEM coagulation hyperparathyroidism thromboelastogram

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Published on: May 23, 2025

Area of Science:

Endocrinology
Hematology
Thrombosis Research

Background:

Hyperparathyroidism is an endocrine disorder characterized by hypercalcemia, impacting calcium homeostasis.
Conflicting results exist regarding the role of hemostasis in hyperparathyroidism.
Thromboelastography is a valuable tool for assessing the entire hemostatic system.

Purpose of the Study:

To investigate the role of hemostatic mechanisms in thrombosis development in primary hyperparathyroidism (PHPT) patients.
To utilize modified rotation thromboelastogram (ROTEM) for assessing hemostatic changes in PHPT.

Main Methods:

A comparative study involving 22 PHPT patients and 20 healthy controls.
Analysis of complete blood count, fibrinogen, D-dimer, prothrombin time, activated prothrombin time, and ROTEM parameters (CT, CFT, MCF).
Thromboelastographic evaluation performed preoperatively and 3 months postoperatively.

Main Results:

Increased clotting time (CT) and clot formation time (CFT) in the INTEM assay for preoperative PHPT patients compared to controls (p = 0.012 for CT).
A trend towards decreased CT and CFT postoperatively, but without statistical significance.
ROTEM analysis indicated a hypocoagulable state in PHPT patients.

Conclusions:

Primary hyperparathyroidism is associated with a hypocoagulable state, detectable by ROTEM.
The observed hemostatic changes in PHPT do not appear to significantly influence increased cardiovascular mortality.
ROTEM is effective in assessing hypercoagulable states in endocrine disorders like PHPT.