Postsurgical Hypoparathyroidism: A Systematic Review.
This article reviews epidemiology, risk factors and treatment modalities of postsurgical hypoparathyroidism (PHypo). PHypo occurs after total thyroidectomy due to injury of parathyroid glands and/or their blood supply or after parathyroidectomy. PHypo results in hypocalcemia because parathyroid hormone (PTH) secretion is impaired and cannot mobilize calcium from bone, reabsorb calcium from the distal nephron and stimulate renal 1α-hydroxylase activity. It usually appears in the first days after surgery and it can be symptomatic or asymptomatic. Risk factors are low level of intraoperative PTH and presence of parathyroid gland in the pathological specimen. Patients usually present with paresthesia, cramps or tetany, but the disorder may also manifest acutely with seizures, bronchospasm, laryngospasm or cardiac rhythm disturbances. Standard treatment is vitamin D analogues and calcium supplementation.
Department of Head and Neck Surgery, Metaxa Anti-Cancer Hospital Piraeus, Piraeus, Greece.
Kassiani
K
Kakava
Laboratory of Research of the Musculoskeletal System (LRMS), School of Medicine, National and Kapodistrian University of Athens, KAT Hospital, Athens, Greece.
Symeon
S
Tournis
Department of Endocrinology, Metaxa Anti-Cancer Hospital Piraeus, Piraeus, Greece george.papadakis.md@gmail.com.
Georgios
G
Papadakis
Department of Head and Neck Surgery, Metaxa Anti-Cancer Hospital Piraeus, Piraeus, Greece.
Ioannis
I
Karelas
Department of Head and Neck Surgery, Metaxa Anti-Cancer Hospital Piraeus, Piraeus, Greece.
Pavlos
P
Stampouloglou
Department of Endocrinology Unit, National and Kapodistrian University of Athens, Laiko General Hospital of Athens, Athens, Greece.
Evanthia
E
Kassi
Laboratory of Research of the Musculoskeletal System (LRMS), School of Medicine, National and Kapodistrian University of Athens, KAT Hospital, Athens, Greece.
Ioannis
I
Triantafillopoulos
Department of Biochemistry, Metaxa Anti-Cancer Hospital Piraeus, Piraeus, Greece.
Vasiliki
V
Villiotou
2nd Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital of Athens, Athens, Greece.
Theodore
T
Karatzas
D002118:Calcium / Q000627:therapeutic use; D006801:Humans; D007011:Hypoparathyroidism / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010280:Parathyroid Glands / Q000378:metabolism* / Q000473:pathology; D010281:Parathyroid Hormone / Q000378:metabolism*; D016105:Parathyroidectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D013965:Thyroidectomy / Q000009:adverse effects; D014807:Vitamin D / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use
D010281:Parathyroid Hormone; D014815:Vitamins; D014807:Vitamin D; D002118:Calcium
Postsurgical hypoparathyroidism; parathormone; parathyroid glands; review; thyroidectomy