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PTH monitoring effective after recovery from permanent hypoparathyroidism
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Recovery from permanent hypoparathyroidism is rare, but serum parathyroid hormone levels should be monitored to avoid unnecessary treatments, such as calcium and vitamin D supplementation, according to recent study findings published in Thyroid.
“Hypoparathyroidism with hypocalcemia is a common complication associated with total thyroidectomy,” the researchers wrote. “In cases of thyroidectomy as a treatment for thyroid cancer, the rate of hypoparathyroidism is higher than that for benign conditions, likely owing to the need for central compartment neck node dissection with or without lateral neck dissection.”
Hang-Seok Chang, MD, PhD, of Gangnam Severance Hospital and Yonsei University College of Medicine in Korea, and colleagues monitored 2,169 patients with thyroid cancer who underwent thyroidectomy with central compartment dissection at the Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine in 2011. The researchers sought to determine the rate of recovery from permanent postoperative hypoparathyroidism in patients who underwent thyroidectomy without parathyroid autotransplantation. Postoperative follow-up was conducted up to 3 years after surgery.
Overall, 1,467 patients underwent total thyroidectomy, and 22 of those experienced permanent postoperative hypoparathyroidism.
Patients with permanent postoperative hypoparathyroidism were mostly women (n = 18), and the mean age was 45.5 years. Serum parathyroid hormone (PTH) was measured in these 22 participants. For at least 1 year after total thyroidectomy, all patients with permanent postoperative hypoparathyroidism had a drop in serum PTH that remained below normal. Within the study period, PTH levels returned to normal in six of those patients; one of these patients was not considered to have recovered due to continued serum hypocalcemia and dependency on vitamin D supplementation. In the other five patients considered as recovered, recovery occurred by 24 months in one and by 30 months in the others. Supplementation with calcium and vitamin D was discontinued after recovery in these five patients.
“In conclusion, the present study demonstrates that recovery from hypoparathyroidism secondary to total thyroidectomy may occur after 2 years after the initial diagnosis in patients not undergoing autotransplantation,” the researchers wrote. “Although this recovery from permanent hypoparathyroidism is relatively rare, the concerned patients should be monitored for recovery of parathyroid function so that unnecessary treatments, such as dietary supplementation of calcium and vitamin D, can be avoided.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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