Cafer Kaya1, Abbas Ali Tam1, Ahmet Dirikoç1, Aylin Kılıçyazgan2, Mehmet Kılıç3, Şeyda Türkölmez4, Reyhan Ersoy5, Bekir Çakır5. 1. Ataturk Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey. 2. Yıldırım Beyazıt University, Department of Pathology, Ankara, Turkey. 3. Yıldırım Beyazıt University, Department of General Surgery, Ankara, Turkey. 4. Ataturk Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey. 5. Yıldırım Beyazıt University, Department of Endocrinology and Metabolism, Ankara, Turkey.
Abstract
OBJECTIVE: Primary hyperparathyroidism (PHP) is a common endocrine disease, and its most effective treatment is surgery. Postoperative hypocalcemia is a morbidity of parathyroid surgeries, and it may extend hospitalization durations. The purpose of this study is to determine the predictive factors related to the development of hypocalcemia and hungry bone syndrome (HBS) in patients who underwent parathyroidectomy for PHP. MATERIALS AND METHODS: Laboratory data comprising parathyroid hormone (PTH), calcium, phosphate, 25-OHD, albumin, magnesium, alkaline phosphatase (ALP), blood urea nitrogen (BUN), and thyroid stimulating hormone (TSH) of the patients were recorded preoperatively, on the 1st and 4th days postoperatively, and in the 6th postoperative month, and their neck ultrasound (US) and bone densitometry data were also recorded. RESULTS: Hypocalcemia was seen in 63 patients (38.4%) on the 1st day after parathyroidectomy. Ten patients (6.1%) had permanent hypocalcemia in the 6th month after surgery. Out of the patients who underwent parathyroidectomy for PHP, 22 (13.4%) had HBS. The incidence of postoperative hypocalcemia was higher in patients who underwent parathyroidectomy for PHP, who had parathyroid hyperplasia, and who had osteoporosis. Preoperative PTH, ALP, and BUN values were higher in those patients who developed HBS. Furthermore, HBS was more common in patients who had osteoporosis, who had parathyroid hyperplasia, and who underwent thyroidectomy simultaneously with parathyroidectomy. CONCLUSIONS: As a result, patients who have the risk factors for development of hypocalcemia and HBS should be monitored more attentively during the perioperative period.
OBJECTIVE: Primary hyperparathyroidism (PHP) is a common endocrine disease, and its most effective treatment is surgery. Postoperative hypocalcemia is a morbidity of parathyroid surgeries, and it may extend hospitalization durations. The purpose of this study is to determine the predictive factors related to the development of hypocalcemia and hungry bone syndrome (HBS) in patients who underwent parathyroidectomy for PHP. MATERIALS AND METHODS: Laboratory data comprising parathyroid hormone (PTH), calcium, phosphate, 25-OHD, albumin, magnesium, alkaline phosphatase (ALP), blood urea nitrogen (BUN), and thyroid stimulating hormone (TSH) of the patients were recorded preoperatively, on the 1st and 4th days postoperatively, and in the 6th postoperative month, and their neck ultrasound (US) and bone densitometry data were also recorded. RESULTS: Hypocalcemia was seen in 63 patients (38.4%) on the 1st day after parathyroidectomy. Ten patients (6.1%) had permanent hypocalcemia in the 6th month after surgery. Out of the patients who underwent parathyroidectomy for PHP, 22 (13.4%) had HBS. The incidence of postoperative hypocalcemia was higher in patients who underwent parathyroidectomy for PHP, who had parathyroid hyperplasia, and who had osteoporosis. Preoperative PTH, ALP, and BUN values were higher in those patients who developed HBS. Furthermore, HBS was more common in patients who had osteoporosis, who had parathyroid hyperplasia, and who underwent thyroidectomy simultaneously with parathyroidectomy. CONCLUSIONS: As a result, patients who have the risk factors for development of hypocalcemia and HBS should be monitored more attentively during the perioperative period.
Authors: Manju Chandran; John P Bilezikian; Nurshazwani Mat Salleh; Hao Ying; Joel Lau; James Lee; Mechteld C deJong; Aye Chan Maung; Rajeev Parameswaran Journal: Osteoporos Sarcopenia Date: 2022-03-24