Post-thyroidectomy hypocalcemia: the role of calcitonin, parathormone and serum albumin.
To investigate the pathogenesis of post-thyroidectomy hypocalcemia calcium, phosphate, calcitonin, parathormone, albumin, triiodothyronine and thyroxine levels were monitored during operation and postoperatively in 25 female patients undergoing bilateral subtotal thyroidectomy for non-toxic nodular goiter. A highly significant fall in uncorrected serum calcium and albumin levels started with the completion of lobectomies and a significant correlation between the course of serum calcium and albumin levels were seen, an early peak in calcitonin corresponded well with the a drop in corrected calcium and inorganic phosphate levels. An overt parathyroid response to hypocalcemia was not observed. We conclude, on the basis of the postoperative hypoalbuminemia, that a calcitonin leak triggered the early onset of hypocalcemia while an insufficient parathyroid response contributed to the post-thyroidectomy hypocalcemia.
Cakmakli
S
S
Department of General Surgery, Faculty of Medicine, University of Ankara, Turkey.
Cavusoglu
T
T
Bumin
C
C
Torun
N
N
D002116:Calcitonin / Q000097:blood*; D005260:Female; D006044:Goiter, Nodular / Q000097:blood / Q000601:surgery; D006801:Humans; D006996:Hypocalcemia / Q000097:blood* / Q000209:etiology*; D010281:Parathyroid Hormone / Q000097:blood*; D010710:Phosphates / Q000097:blood; D011183:Postoperative Complications / Q000097:blood* / Q000209:etiology*; D012709:Serum Albumin / Q000378:metabolism*; D013965:Thyroidectomy / Q000009:adverse effects*; D013974:Thyroxine / Q000097:blood; D013997:Time Factors; D014284:Triiodothyronine / Q000097:blood
D010281:Parathyroid Hormone; D010710:Phosphates; D012709:Serum Albumin; D014284:Triiodothyronine; D002116:Calcitonin; D013974:Thyroxine