American Association of Clinical Endocrinologists and American College of Endocrinology Disease State Clinical Review: Postoperative Hypoparathyroidism - Definitions and Management

Stack, Brendan C.; Bimston, David N.; Bodenner, Donald; Brett, Elise M.; Dralle, Henning; Orloff, Lisa A.; Pallota, Johanna; Snyder, Samuel K.; Wong, Richard J.; Randolph, Gregory W.

doi:10.4158/ep14462.dsc

Cited by 214 publications

(263 citation statements)

References 48 publications

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“…There is a lack of consensus on PH definition (2). European guidelines define PH as low levels of parathyroid hormone (PTH) and need for replacement therapy 6 months after surgery (3) whereas other reports consider PH 1 year after thyroidectomy (2,4). We did propose to use the 1-year deadline since according to our data (unpublished) about one third of patients recover from protracted hypoparathyroidism after 6 months.…”

Section: Introductionmentioning

confidence: 99%

“…Renal imaging is recommended in case patient develops symptoms of renal stone disease or if serum creatinine levels start to rise and they advise against routine monitoring of bone mineral density by dual energy X-ray absorptiometry (DXA) scans. The American Association of Clinical Endocrinologist (AACE) and the American College of Endocrinology (ACE) published a Disease State Clinical Review (4) in which the frequency of biochemical surveillance is not specified, but their recommendations regarding periodic renal ultrasound and DXA scans were similar.…”

Section: Original Articlementioning

confidence: 99%

“…There is wide consensus (3)(4)(5) that the best replacement treatment for PH consists of calcium salts associated with active vitamin D analogues to maintain sCa concentrations between 2 mmol/L (8 mg/dL) and the lower limit of the reference avoiding hypocalcemic symptoms. No formal recommendations have been agreed regarding the most appropriate vitamin D analogue.…”

Section: Original Articlementioning

confidence: 99%

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Clinical profile and long-term follow-up of 32 patients with postoperative permanent hypoparathyroidism

et al. 2017

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Background: Parathyroid failure is the most common complication after total thyroidectomy but permanent impairment of the parathyroid function is unusual. Limited data is available assessing long-term follow-up, quality of life and complications occurring in patients with permanent hypoparathyroidism (PH).We aimed to assess the incidence of complications derived from PH status, their influence on the quality of life perceived by PH patients and its relation to standard medical treatment with calcium salts and active vitamin D analogues.Methods: Cross-sectional observational study of consecutive patients undergoing total thyroidectomy who developed PH and were followed at least twice a year at a referral endocrine surgery unit. PH was defined as intact parathyroid hormone (iPTH) levels <13 pg/mL and the need for replacement therapy with calcium and/or vitamin D for at least 1 year after surgery. Quality of life was assessed using the SF-36 questionnaire.Data regarding doses and type of vitamin D analogues and calcium supplementation, serum calcium fluctuations, bone densitometry and renal ultrasound were recorded. Results:The cohort included 32 patients (3 male/29 female) with a mean age of 51.2±15.2 years. The mean follow-up was 78±68 months and the total follow-up length was 70,080 PH patient/days. Five (15.6%) patients showed a decreased renal function. At least one clinical adverse event was observed in 18 (56.3%)patients. There was a slight decrease of the punctuation in the SF-36 questionnaire for the perceived quality of life that was only significant for the emotional role.Conclusions: PH and its treatment carry a mild to moderate burden of illness if followed closely. During a mean follow-up of nearly 6 years, only half of the patients suffered a relevant clinical event with little impact on their quality of life.

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Section: Introductionmentioning

confidence: 99%

Section: Original Articlementioning

confidence: 99%

Section: Original Articlementioning

confidence: 99%

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Clinical profile and long-term follow-up of 32 patients with postoperative permanent hypoparathyroidism

et al. 2017

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“…If serum 25-OHD level is less, adequate replacement with cholecalciferol (60,000 IU once weekly for 4-8 weeks) should be considered. 42 In patients with unknown vitamin D status, empirical vitamin D replacement may still be considered. Although this may hopefully decrease the rates of postoperative hypocalcemia, this has not been documented in clinical trials.…”

Section: Preoperative Strategies To Prevent Postoperative Hypocalcemiamentioning

confidence: 99%

“…Although this may hopefully decrease the rates of postoperative hypocalcemia, this has not been documented in clinical trials. 42 Care should be taken not to worsen hypercalcemia in undiagnosed patients with primary or tertiary hyperparathyroidism.…”

Section: Preoperative Strategies To Prevent Postoperative Hypocalcemiamentioning

confidence: 99%

Hypocalcemia: What a Surgeon should know

Mayilvaganan¹,

Kolly²,

Sarathi³

et al. 2017

World Journal of Endocrine Surgery

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Hypocalcemia is one of the sequelae following thyroidectomy (TT) and becomes a complication when it becomes permanent. Parathyroid preservation is a crucial step in the skillful operative procedure of TT. When due care is not taken, the surgeon and the treating physician are faced with the issue of treating the dreaded complication of permanent hypocalcemia. In this article, we address the issue of hypocalcemia following thyroid surgery and its management.

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Association Between Annual Surgeon Total Thyroidectomy Volume and Transient and Permanent Complications

Meltzer

Hull

Sundang³

et al. 2019

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Although the association between annual surgeon total thyroidectomy volume and clinical outcomes is well established, published methods typically group surgeons into volume categories. The volume-outcomes association is likely continuous, but little is known about the point at which the annual surgeon procedure volumes begin to be associated with a decrease in complication rates. OBJECTIVE To model the volume-outcomes association as a continuous function and identify the point at which increasing surgeon volume begins yielding better outcomes.

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American Association of Clinical Endocrinologists and American College of Endocrinology Disease State Clinical Review: Postoperative Hypoparathyroidism - Definitions and Management

Cited by 214 publications

References 48 publications

Clinical profile and long-term follow-up of 32 patients with postoperative permanent hypoparathyroidism

Clinical profile and long-term follow-up of 32 patients with postoperative permanent hypoparathyroidism

Hypocalcemia: What a Surgeon should know

Association Between Annual Surgeon Total Thyroidectomy Volume and Transient and Permanent Complications

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