In reply
Elevated PTH levels in the setting of normal serum calcium levels after successful parathyroidectomy for primary hyperparathyroidism (pHPT) can be disconcerting to referring physicians and treating surgeons alike, with the etiology and clinical significance of elevated PTH levels unclear. Among other issues that remain, the significance of elevated PTH levels in younger patients, particularly children, after parathyroidectomy is not clearly understood.