Hypoparathyroidism after Total Parathyroidectomy plus Subcutaneous Autotransplantation for Secondary Hyperparathyroidism-Any Side Effects?
Summary of "Hypoparathyroidism after Total Parathyroidectomy plus Subcutaneous Autotransplantation for Secondary Hyperparathyroidism-Any Side Effects?"
BACKGROUND:
This retrospective, case-control study was designed to find side effects of hypoparathyroidism after total parathyroidectomy plus autotransplantation.
METHODS:
After successful total parathyroidectomy plus autotransplantation for symptomatic secondary hyperparathyroidism, 19 patients who had intact parathyroid hormone (iPTH) levels <10 pg/ml during the follow-up period of 1 year and 38 patients, who had levels >10 pg/ml, were enrolled as the hypoparathyroid and nonhypoparathyroid groups. Data were collected on etiology, symptoms, serum levels of calcium, phosphate, alkaline phosphatase (Alk-ptase), iPTH, and bone mineral density (BMD) at different sites. Then, 1 week, 3 months, and 1 year after surgery, serum levels of calcium, phosphate, Alk-ptase, and iPTH were measured again. Three months later, symptoms were recorded. One year after surgery, the BMD at different sites was measured again. Patients' daily requirements of calcium carbonate and vitamin D3 were recorded at the mean follow-up of 24 months.
RESULTS:
Calcium, phosphate, and iPTH levels decreased significantly 1 week, 3 months, and 1 year after surgery, and Alk-ptase levels increased at 1 week and then decreased significantly 3 months and 1 year after surgery. Symptoms improved significantly 3 months after surgery. The BMD of different sites increased significantly at 1 year. There were no differences between the two groups regarding changes of symptoms, BMD, and calcium, phosphate, and Alk-ptase levels. Hypoparathyroid patients required significantly more calcium carbonate and vitamin D3 than nonhypoparathyroid patients did (P = 0.002).
CONCLUSIONS:
Even though hypoparathyroid patients require more calcium carbonate and vitamin D3 than nonhypoparathyroid patients do, they do not have any side effects.
Affiliation
Department of Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, 833, Taiwan, ROC.
Journal Details
This article was published in the following journal.
Name: World journal of surgery
ISSN: 1432-2323
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20635084
- DOI: http://dx.doi.org/10.1007/s00268-010-0711-1
Medical and Biotech [MESH] Definitions
Parathyroidectomy
Excision of one or both of the parathyroid glands.
Subcutaneous Emphysema
Presence of air or gas in the subcutaneous tissues of the body.
Skinfold Thickness
The measurement of subcutaneous fat located directly beneath the skin by grasping a fold of skin and subcutaneous fat between the thumb and forefinger and pulling it away from the underlying muscle tissue. The thickness of the double layer of skin and subcutaneous tissue is then read with a caliper. The five most frequently measured sites are the upper arm, below the scapula, above the hip bone, the abdomen, and the thigh. Its application is the determination of relative fatness, of changes in physical conditioning programs, and of the percentage of body fat in desirable body weight. (From McArdle, et al., Exercise Physiology, 2d ed, p496-8)
Pyonephrosis
Distention of KIDNEY with the presence of PUS and suppurative destruction of the renal parenchyma. It is often associated with renal obstruction and can lead to total or nearly total loss of renal function.
Von Willebrand Disease, Type 3
A subtype of von Willebrand disease that results from a total or near total deficiency of VON WILLEBRAND FACTOR.
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