Serum intact parathyroid hormone as a predictor of hypocalcaemia after total thyroidectomy.
BACKGROUND
Hypocalcaemia from hypoparathyroidism is a complication of total thyroidectomy. The aim of the present study was to determine whether an early postoperative level of serum parathyroid hormone (PTH) after total thyroidectomy predicts the development of significant hypocalcaemia and the need for treatment.


METHODS
Patients undergoing total thyroidectomy had their serum level of intact PTH checked 1 h after removal of the thyroid gland. Serum calcium level was checked on the following morning. Oral calcium and/or calcitriol was commenced if the patient developed hypocalcaemic symptoms, or if the corrected serum calcium level was <2.0 mmol/L.


RESULTS
Seventy-nine patients were included in the present study. Thirteen patients had symptoms of hypocalcaemia on postoperative days 1 or 2 and 66 patients remained asymptomatic. The postoperative intact PTH, day 1 calcium and day 2 calcium was 0.32 +/- 0.60 pmol/L, 2.01 +/- 0.11 mmol/L, and 2.02 +/- 0.16 mmol/L, respectively, for the symptomatic group and 1.98 +/- 1.25, 2.21 +/- 0.13, and 2.19 +/- 0.14, respectively, for the asymptomatic group. Calcium support was given to 25 patients, of whom 14 also required calcitriol.


CONCLUSIONS
Serum PTH 1-h after total thyroidectomy is a reliable predictor of hypocalcaemia and can allow safe early discharge of patients from hospital.
Soon
Patsy S H
PS
Endocrine Surgical Unit, St George Hospital, New South Wales, Australia. patsysoon@med.usyd.edu.au
Magarey
Christopher J
CJ
Campbell
Peter
P
Jalaludin
Bin
B
D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011183:Postoperative Complications; D013965:Thyroidectomy
D010281:Parathyroid Hormone