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Minerva Endocrinologica 2020 Dec 03

DOI: 10.23736/S0391-1977.20.03291-5


lingua: Inglese

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


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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