title: Unusually high serum levels of lactate dehydrogenase without perivalvular leakage following double valve replacement: predictor of tetany attack after thyroidectomy.
abstract: A 57-year-old woman who complained of exertional dyspnea was diagnosed as having severe aortic valve stenosis and mitral valve regurgitation. The patient underwent double valve replacement with a mechanical prosthesis. Postoperative laboratory data showed unusually high serum lactate dehydrogenase (LDH) levels, even though no perivalvular leakage was detected by echocardiography. Tetany occurred suddenly owing to hypoparathyroidism, which seemed to be a late complication after thyroidectomy. After calcium administration, the symptoms dramatically diminished, as did the serum LDH levels. Hypoparathyroidism should be doubted if serum LDH levels increase higher than the normal range following valve replacement without obvious perivalvular leakage.
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. mryomoto@hyo-med.ac.jp
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ryomoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Masataka
authors.initials: M
authors.lastname: Mitsuno
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yamamura
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Ohata
authors.forename: Hiroe
authors.initials: H
authors.lastname: Tanaka
mesh_terms: D001024:Aortic Valve Stenosis / Q000601:surgery; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007011:Hypoparathyroidism / Q000150:complications / Q000201:enzymology; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery; D010281:Parathyroid Hormone / Q000097:blood; D011237:Predictive Value of Tests; D013746:Tetany / Q000097:blood / Q000201:enzymology* / Q000209:etiology*; D013965:Thyroidectomy / Q000009:adverse effects*; D013966:Thyroiditis / Q000601:surgery
chemical_list: D010281:Parathyroid Hormone; D007770:L-Lactate Dehydrogenase