Adenoma weight: A predictor of transient hypocalcemia after parathyroidectomy

Zamboni, William A.; Folse, Roland

doi:10.1016/0002-9610(86)90436-8

Cited by 61 publications

(49 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has been found that an increased glandular mass correlates with the severity of primary hyperparathyroidism and the subsequent risk of transient postoperative hypocalcemia (7). Because of the high secretory output, as measured by intact parathormone levels the major proportion of this enlarged gland was probably hypereractive because of its increased cellularity.…”

Section: Discussionmentioning

confidence: 99%

Giant mediastinal parathyroid adenoma

Çakmak¹

2011

Tuberk Toraks

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Giant mediastinal parathyroid adenoma

Çakmak¹

2011

Tuberk Toraks

View full text Add to dashboard Cite

show abstract

“…Data on the prevalence of HBS have been scarce and conflicting after original publications in the 1980s of large case series suggesting that the syndrome develops post-operatively in up to 13% of patients with PHPT (1,3,30). Recent case series from Asia reported much higher prevalence rates of 24-87% (31,32,33,34), whereas a case series from Saudi Arabia documented a prevalence rate of only 4% (35).…”

Section: Prevalence Of Hbs After Parathyroidectomymentioning

confidence: 99%

“…This decrease in serum calcium levels is usually mild and maximal 2-4 days post-operatively, and independent of the size of hyperactive glands or pathological diagnosis (1,2,3,4,5,6,7,8). Persistence of hypocalcaemia for more than 4 days after parathyroidectomy may be due to intentional or accidental removal of all parathyroid glands, devascularisation or trauma to residual parathyroid glands, but is also often due to long-term suppression of residual non-pathological parathyroid glands (1,2,8,9).…”

Section: Introductionmentioning

confidence: 99%

THERAPY OF ENDOCRINE DISEASE: Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature

Witteveen

Thiel

Romijn

et al. 2013

European Journal of Endocrinology

280

220

View full text Add to dashboard Cite

Hungry bone syndrome (HBS) refers to the rapid, profound, and prolonged hypocalcaemia associated with hypophosphataemia and hypomagnesaemia, and is exacerbated by suppressed parathyroid hormone (PTH) levels, which follows parathyroidectomy in patients with severe primary hyperparathyroidism (PHPT) and preoperative high bone turnover. It is a relatively uncommon, but serious adverse effect of parathyroidectomy. We conducted a literature search of all available studies reporting a 'hungry bone syndrome' in patients who had a parathyroidectomy for PHPT, to identify patients at risk and address the pitfalls in their management. The severe hypocalcaemia is believed to be due to increased influx of calcium into bone, due to the sudden removal of the effect of high circulating levels of PTH on osteoclastic resorption, leading to a decrease in the activation frequency of new remodelling sites and to a decrease in remodelling space, although there is no good documentation for this. Various risk factors have been suggested for the development of HBS, including older age, weight/volume of the resected parathyroid glands, radiological evidence of bone disease and vitamin D deficiency. The syndrome is reported in 25-90% of patients with radiological evidence of hyperparathyroid bone disease vs only 0-6% of patients without skeletal involvement. There is insufficient data-based evidence on the best means to treat, minimise or prevent this severe complication of parathyroidectomy. Treatment is aimed at replenishing the severe calcium deficit by using high doses of calcium supplemented by high doses of active metabolites of vitamin D. Adequate correction of magnesium deficiency and normalisation of bone turnover are required for resolution of the hypocalcaemia which may last for a number of months after successful surgery. Preoperative treatment with bisphosphonates has been suggested to reduce post-operative hypocalcaemia, but there are to date no prospective studies addressing this issue. European Journal of Endocrinology 168 R45-R53

show abstract

“…However, results from different studies have been variable. Randhawa et al [12] observed no relationship between serum calcium and PTH levels and adenoma weight or volume while other studies [7,13,14] demonstrated significant correlations between preoperative serum calcium and PTH and adenoma weight. No consensus has been reached, however, on whether parathyroid weight alone can predict postoperative hypocalcaemia.…”

Section: Discussionmentioning

confidence: 93%

“…Correlation between serum PTH and adenoma weight has been studied by several authors [7][8][9][10][11][12][13][14], as well as serum calcium and adenoma weight [7]. However, results from different studies have been variable.…”

Section: Discussionmentioning

confidence: 99%

Parathyroid Hormone as a Marker for Predicting the Severity of Hypocalcaemia Following Parathyroidectomy

Sekhar

Nayak

Suhasini

et al. 2015

Indian J Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

The purpose of this study is to determine preoperative predictors of the severity of the hypocalcaemia following parathyroidectomy. The case records of 70 patients who underwent parathyroidectomy for primary hyperparathyroidism from 2000 to 2013 was retrospectively studied. Their symptoms at presentation, biochemical parameters serum calcium, parathyroid hormone, alkaline phosphatase and parathyroid size on ultrasound were compared with their serial post-operative serum calcium levels at 24, 48, 72 and 96 h. For the purpose of analysis, patients were divided into three groups. Group 1-asymptomatic, biochemically normal (serum calcium always C8.5 mgs%); Group 2-asymptomatic, biochemically below normal (at least one reading \8.5, but none \8.0); Group 3-symptomatic (any one reading\8.0). No correlation was found between the severity of the presenting symptoms, pre-operative serum calcium levels or the parathyroid size with the post-operative calcium levels in the three groups. Though preoperative serum alkaline phosphatase levels were higher in Group 3, it was not statistically significant (p = 0.069). However, preoperative serum parathyroid hormone levels significantly correlated with postoperative serum calcium levels in all three groups (p = 0.006). Pre-operative serum parathyroid hormone levels may serve as a marker for severe post-operative hypocalcaemia and thus identify patients requiring closer monitoring and longer hospitalization following parathyroidectomy.

show abstract

Adenoma weight: A predictor of transient hypocalcemia after parathyroidectomy

Cited by 61 publications

References 3 publications

Giant mediastinal parathyroid adenoma

Giant mediastinal parathyroid adenoma

THERAPY OF ENDOCRINE DISEASE: Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature

Parathyroid Hormone as a Marker for Predicting the Severity of Hypocalcaemia Following Parathyroidectomy

Contact Info

Product

Resources

About