open access

Vol 57, No 5 (2006)
Original papers
Published online: 2006-11-06
Submitted: 2013-02-15
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Hypoparathyroidism after surgery on thyroid cancer: is there a delayed chance for recovery after a prolonged period of substitutive therapy?

Beata Jurecka-Lubieniecka, Ewa Paliczka, Agnieszka Czarniecka, Michał Jarząb, Daria Handkiewicz, Kornelia Hasse-Lazar, Aleksandra Kukulska
Endokrynologia Polska 2006;57(5):501-508.

open access

Vol 57, No 5 (2006)
Original papers
Published online: 2006-11-06
Submitted: 2013-02-15

Abstract

Introduction: Transient and persistent hypoparathyroidism (HPT) belong to the well known complications of total thyroidectomy performed because of thyroid carcinoma. The true frequency of persistent hypoparathyroidism is often higher than estimated in the reports published by the specialized centers with low rate of complications.
The aim of the study: Investigation whether the repeated check-up, performed over 2 years post thyroidectomy, reveals some cases of recovery in patients diagnosed with persistent HPT post thyroid cancer surgery.
Material and methods: In total, 115 patients were included into the study, all of them treated with vitamin D derivatives and calcium supplementation. In 17 of them a diagnosis of transient hypoparathyroidism was made on the basis of evaluation performed 6 months after surgery, the remaining 98 were diagnosed with persistent HPT. Parathyroid (PTH) function was reevaluated after withdrawal of active vitamin D derivatives for 10 days and of calcium carbonate for two days during the hospital stay in patients admitted for radioiodine scan, thus after thyroxine withdrawal. The control group consisted of 123 DTC (differentiated thyroid carcinoma) patients without parathyroid dysfunction.
On the basis of intact PTH serum level and calcium and phosphorus estimations HPT was unequivocally confirmed in 49 patients (50%). The remaining 49 patients exhibited normal PTH level and in 43 (86%) of them Ca2+ level was also within normal range, thus delayed, recovery from HPT was stated.
Results: Our results indicate that reevaluation of hypoparathyroidism post total thyreoidectomy is necessary, as delayed recover of parathyroid dysfunction is a frequent phenomenon. We also propose criteria of reevaluation of HTP in patients on chronic substitutive therapy.

Abstract

Introduction: Transient and persistent hypoparathyroidism (HPT) belong to the well known complications of total thyroidectomy performed because of thyroid carcinoma. The true frequency of persistent hypoparathyroidism is often higher than estimated in the reports published by the specialized centers with low rate of complications.
The aim of the study: Investigation whether the repeated check-up, performed over 2 years post thyroidectomy, reveals some cases of recovery in patients diagnosed with persistent HPT post thyroid cancer surgery.
Material and methods: In total, 115 patients were included into the study, all of them treated with vitamin D derivatives and calcium supplementation. In 17 of them a diagnosis of transient hypoparathyroidism was made on the basis of evaluation performed 6 months after surgery, the remaining 98 were diagnosed with persistent HPT. Parathyroid (PTH) function was reevaluated after withdrawal of active vitamin D derivatives for 10 days and of calcium carbonate for two days during the hospital stay in patients admitted for radioiodine scan, thus after thyroxine withdrawal. The control group consisted of 123 DTC (differentiated thyroid carcinoma) patients without parathyroid dysfunction.
On the basis of intact PTH serum level and calcium and phosphorus estimations HPT was unequivocally confirmed in 49 patients (50%). The remaining 49 patients exhibited normal PTH level and in 43 (86%) of them Ca2+ level was also within normal range, thus delayed, recovery from HPT was stated.
Results: Our results indicate that reevaluation of hypoparathyroidism post total thyreoidectomy is necessary, as delayed recover of parathyroid dysfunction is a frequent phenomenon. We also propose criteria of reevaluation of HTP in patients on chronic substitutive therapy.
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Keywords

thyroid surgery; complications; hypocalcemia; hypoparathyroidism

About this article
Title

Hypoparathyroidism after surgery on thyroid cancer: is there a delayed chance for recovery after a prolonged period of substitutive therapy?

Journal

Endokrynologia Polska

Issue

Vol 57, No 5 (2006)

Pages

501-508

Published online

2006-11-06

Bibliographic record

Endokrynologia Polska 2006;57(5):501-508.

Keywords

thyroid surgery
complications
hypocalcemia
hypoparathyroidism

Authors

Beata Jurecka-Lubieniecka
Ewa Paliczka
Agnieszka Czarniecka
Michał Jarząb
Daria Handkiewicz
Kornelia Hasse-Lazar
Aleksandra Kukulska

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