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18-04-2024 | Hypocalcemia | Original Article

A prospective cross-sectional study on hypocalcemia after total thyroidectomy in patients with Graves’ disease: insights on secondary hyperparathyroidism

Authors: Hiroyuki Yamashita, Shinya Sato, Hisakazu Shindo, Yusuke Mori, Kouichi Yoshimoto, Seigo Tachibana, Takashi Fukuda, Hiroshi Takahashi

Published in: Surgery Today

Abstract

Purpose

To investigate the parathyroid function and calcium (Ca) levels in the secondary hyperparathyroidism (SHPT) state in patients with Graves’ disease.

Methods

We examined 31 consecutive patients with Graves’ disease without chronic kidney disease, who were treated with total thyroidectomy. The patients were divided into a normal parathyroid hormone (PTH) group (NPTH group; n = 19) with a PTH level ≤ 65 pg/mL, and a secondary hyperparathyroidism group (SHPT group; n = 12), with a PTH level > 65 pg/mL. The PTH and Ca-related parameters were examined and the risk factors for postoperative hypocalcemia were analyzed.

Results

The preoperative Ca level was significantly lower (2.24 ± 0.06 vs. 2.31 ± 0.07 mmol/L, p < 0.05) in the SHPT group than in the NPTH group. The reduction in PTH, 1,25-dihydroxyvitamin D (1,25(OH)2D), and Ca levels from the preoperative day to the next morning was significantly greater in the SHPT group than in the NPTH group (p < 0.05). When intraoperative factors were included, the decrease in the PTH level alone was significant. SHPT was a significant factor in determining the extent of PTH reduction.

Conclusions

Hyperfunctioning parathyroid glands in the SHPT state were more susceptible to postoperative PTH reduction, which, combined with low preoperative Ca levels, increased the risk of postoperative hypocalcemia in patients with Graves’ disease.

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Title: A prospective cross-sectional study on hypocalcemia after total thyroidectomy in patients with Graves’ disease: insights on secondary hyperparathyroidism
Authors: Hiroyuki Yamashita
Shinya Sato
Hisakazu Shindo
Yusuke Mori
Kouichi Yoshimoto
Seigo Tachibana
Takashi Fukuda
Hiroshi Takahashi
Publication date: 18-04-2024
Publisher: Springer Nature Singapore
Keywords: Hypocalcemia
Thyroidectomy
Thyroidectomy
Hyperparathyroidism
Published in: Surgery Today
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-024-02848-4

At a glance: The STEP trials

Springer Medicine

A prospective cross-sectional study on hypocalcemia after total thyroidectomy in patients with Graves’ disease: insights on secondary hyperparathyroidism

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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