Postoperative Hypoparathyroidism: Presentation, Clinical Features and Long-term Follow-up from Tertiary Care Hospital OC18-OC20
Shrikrishna V Acharya,
Associate Professor, Department of Endocrinology, K S Hegde Medical Academy,
Deralakatte, Mangalore, Karnataka, India.
Introduction: Hypoparathyroidism is commonly seen after total thyroidectomy. Though most of the time it is transient in nature but permanent decrease in function of the parathyroid function is also possible.
Aim: A retrospective analysis of clinical presentation, treatment, prevalence of complications of hypoparathyroidism and its treatment with active vitamin D analogues was conducted.
Materials and Methods: A retrospective cohort study followed by location and duration of study of all patients who developed Permanent Hypoparathyroidism (PH) and who were regular in follow-up for at least three years. Any patient with intact Parathyroid Hormone (iPTH) levels <13 pg/mL and was on replacement therapy with calcium and/ or vitamin D for at least one year after surgery is labelled as PH. Data of their treatment, serum calcium, phosphorous, creatinine, urine calcium/creatinine ratio and renal ultrasound was recorded. Data was represented as percentage, mean and standard deviation. Statistical analysis was conducted using SPSS version 19.
Results: Out of the 23 patients enrolled, three were male and 20 were female with a mean age of 41.2±15.2 years. The mean duration of follow-up was 48±28 months. Clinical complications in 12 patients were observed. Two patients developed renal colic due to renal stone on follow-up. None of the patients developed renal failure.
Conclusion: PH causes considerable morbidity and economic burden to family due to its lifelong treatment and monitoring. It requires regular follow-up and monitoring to prevent complications of disease as well as its treatment with active calcium salts. Around 50% of the patients suffered few relevant clinical events requiring hospitalisation.