POSTOPERATIVE
HYPOCALCEMIA IN HYPERTHYROIDISM
Transient
postoperative hypocalcemia occurs with a higher frequency in hyperthyroid
patients than in euthyroid patients (30 % vs. 13 %). Common causes of
post-thyroidectomy hypocalcemia are
damage, devascularization or inadvertent removal of parathyroid glands, but for
hyperthyroid patients another potential mechanism is the ‘hungry bone
syndrome’, due to postoperative reversal of thyrotoxic osteodystrophy.
Practical implications include preoperative administration of Vitamin D
supplements (when indicated based on serum Vit D levels) and careful
postoperative follow-up with serum calcium measurement to promptly detect
hypocalcemia and –when appropriate – adequate calcium and Vit D supplementation
to prevent hypocalcemia-related symptoms. Another useful clinical strategy
includes prophylactic administration of calcium and Vit D administration in all
patients following thyroidectomy for Graves’ disease.
J
Otolaryngol-Head Neck Surg 2018; 47:6
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