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Minerva Endocrinologica 2020 Dec 03

DOI: 10.23736/S0391-1977.20.03291-5

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Evaluation of management of patients with postoperative permanent hypoparathyroidism. How close are we to the
targets?

Cagatay E. ONDER, Serife M. KUSKONMAZ, Gonul KOC 1, Sevde N. FIRAT, Tulay OMMA, Cavit CULHA

Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey


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BACKGROUND: Postoperative hypoparathyroidism (PO-HypoPT) is a complication usually seen after thyroid surgery. PO-HypoPT, which lasts longer than 6 months is defined permanently. The aim of this study is to evaluate how close permanent POHypoPT patients can approach target values.
MATERIALS AND METHODS: 107 patients who were followed up with permanent diagnosis of PO-HypoPT between 2016-2020 were included in the study. The study protocol includes serum albumin corrected total calcium (Alb-sCa), phosphate (P), Ca-P product, and 24 h urine calcium measurements. Laboratory measurements of the patients include the values recorded in 4-year visits and in the last visit. In addition, radiological reports of renal/abdominal ultrasound and cranial tomography examinations performed in our hospital for any reason during this period were also reviewed.
RESULTS: When looking at the total measurements in the 4-year period; the Alb-sCa level was below the target in most of the measurements (68.1%). P level was higher than normal in 296 (46.2%) measurements. 24 h urine ca excretion was measured 185 times in total visits, and 81 (43.7%) of these measurements showed hypercalciuric values. The patient's latest visit measurements were evaluated on 4 targets (Alb-sCa, P, Ca-P product and 24 h urine Ca excretion). The number of patients meeting all four targets was only 21 (19.6%). 6 (7.5%) patients had kidney stones or nephrocalcinosis. 3 (0.09%) patients with imaging had calcification in the basal ganglia.
CONCLUSIONS: Our study shows that the management of the patients with PO-HypoPT is suboptimal with active vitamin D and cholecalciferol treatment.


KEY WORDS: Postoperative hypoparathyroidism; Permanent hypoparathyroidism, Hypocalcemia

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