Skip to main content
Top
Published in: Osteoporosis International 11/2011

01-11-2011 | Case Report

Low bone turnover and increase of bone mineral density in a premenopausal woman with postoperative hypoparathyroidism and thyroxine suppressive therapy

Authors: K. Amrein, H. P. Dimai, H. Dobnig, A. Fahrleitner-Pammer

Published in: Osteoporosis International | Issue 11/2011

Login to get access

Abstract

We report the case of a 36-year-old woman who developed permanent hypoparathyroidism after thyroidectomy for differentiated thyroid carcinoma. A 6-year follow-up showed an increase of 11% in absolute bone mineral density at the spine and 6% at the hip accompanied by low bone turnover despite thyroid-stimulating hormone suppressive thyroxine therapy.
Literature
1.
go back to reference Asari R, Passler C, Kaczirek K, Scheuba C, Niederle B (2008) Hypoparathyroidism after total thyroidectomy: a prospective study. Arch Surg 143:132–137, discussion 138PubMedCrossRef Asari R, Passler C, Kaczirek K, Scheuba C, Niederle B (2008) Hypoparathyroidism after total thyroidectomy: a prospective study. Arch Surg 143:132–137, discussion 138PubMedCrossRef
2.
go back to reference Thomusch O, Machens A, Sekulla C, Ukkat J, Brauckhoff M, Dralle H (2003) The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surgery 133:180–185PubMedCrossRef Thomusch O, Machens A, Sekulla C, Ukkat J, Brauckhoff M, Dralle H (2003) The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surgery 133:180–185PubMedCrossRef
3.
go back to reference Roher HD, Goretzki PE, Hellmann P, Witte J (1999) Complications in thyroid surgery. incidence and therapy. Chirurg 70:999–1010PubMedCrossRef Roher HD, Goretzki PE, Hellmann P, Witte J (1999) Complications in thyroid surgery. incidence and therapy. Chirurg 70:999–1010PubMedCrossRef
4.
go back to reference Dralle H (2009) Identification of the recurrent laryngeal nerve and parathyroids in thyroid surgery. Chirurg 80:352–363PubMedCrossRef Dralle H (2009) Identification of the recurrent laryngeal nerve and parathyroids in thyroid surgery. Chirurg 80:352–363PubMedCrossRef
5.
go back to reference Testini M, Gurrado A, Lissidini G, Nacchiero M (2007) Hypoparathyroidism after total thyroidectomy. Minerva Chir 62:409–415PubMed Testini M, Gurrado A, Lissidini G, Nacchiero M (2007) Hypoparathyroidism after total thyroidectomy. Minerva Chir 62:409–415PubMed
6.
go back to reference Thomusch O, Machens A, Sekulla C, Ukkat J, Lippert H, Gastinger I, Dralle H (2000) Multivariate analysis of risk factors for postoperative complications in benign goiter surgery: prospective multicenter study in Germany. World J Surg 24:1335–1341PubMedCrossRef Thomusch O, Machens A, Sekulla C, Ukkat J, Lippert H, Gastinger I, Dralle H (2000) Multivariate analysis of risk factors for postoperative complications in benign goiter surgery: prospective multicenter study in Germany. World J Surg 24:1335–1341PubMedCrossRef
7.
go back to reference Chen Q, Kaji H, Iu MF, Nomura R, Sowa H, Yamauchi M, Tsukamoto T, Sugimoto T, Chihara K (2003) Effects of an excess and a deficiency of endogenous parathyroid hormone on volumetric bone mineral density and bone geometry determined by peripheral quantitative computed tomography in female subjects. J Clin Endocrinol Metab 88:4655–4658PubMedCrossRef Chen Q, Kaji H, Iu MF, Nomura R, Sowa H, Yamauchi M, Tsukamoto T, Sugimoto T, Chihara K (2003) Effects of an excess and a deficiency of endogenous parathyroid hormone on volumetric bone mineral density and bone geometry determined by peripheral quantitative computed tomography in female subjects. J Clin Endocrinol Metab 88:4655–4658PubMedCrossRef
8.
go back to reference Abugassa S, Nordenstrom J, Eriksson S, Sjoden G (1993) Bone mineral density in patients with chronic hypoparathyroidism. J Clin Endocrinol Metab 76:1617–1621PubMedCrossRef Abugassa S, Nordenstrom J, Eriksson S, Sjoden G (1993) Bone mineral density in patients with chronic hypoparathyroidism. J Clin Endocrinol Metab 76:1617–1621PubMedCrossRef
9.
go back to reference Chan FK, Tiu SC, Choi KL, Choi CH, Kong AP, Shek CC (2003) Increased bone mineral density in patients with chronic hypoparathyroidism. J Clin Endocrinol Metab 88:3155–3159PubMedCrossRef Chan FK, Tiu SC, Choi KL, Choi CH, Kong AP, Shek CC (2003) Increased bone mineral density in patients with chronic hypoparathyroidism. J Clin Endocrinol Metab 88:3155–3159PubMedCrossRef
10.
go back to reference Duan Y, De Luca V, Seeman E (1999) Parathyroid hormone deficiency and excess: similar effects on trabecular bone but differing effects on cortical bone. J Clin Endocrinol Metab 84:718–722PubMedCrossRef Duan Y, De Luca V, Seeman E (1999) Parathyroid hormone deficiency and excess: similar effects on trabecular bone but differing effects on cortical bone. J Clin Endocrinol Metab 84:718–722PubMedCrossRef
11.
go back to reference Hawkins F, Escobar-Jimenez F, Jodar E, Campos MM, Lopez Alvarez MB, Martinez Diaz-Guerra G (2003) Bone mineral density in hypoparathyroid women on LT4 suppressive therapy. Effect of calcium and 1, 25(OH)2 vitamin D3 treatment. J Musculoskelet Neuronal Interact 3:71–76PubMed Hawkins F, Escobar-Jimenez F, Jodar E, Campos MM, Lopez Alvarez MB, Martinez Diaz-Guerra G (2003) Bone mineral density in hypoparathyroid women on LT4 suppressive therapy. Effect of calcium and 1, 25(OH)2 vitamin D3 treatment. J Musculoskelet Neuronal Interact 3:71–76PubMed
12.
go back to reference Winer KK, Ko CW, Reynolds JC, Dowdy K, Keil M, Peterson D, Gerber LH, McGarvey C, Cutler GB Jr (2003) Long-term treatment of hypoparathyroidism: a randomized controlled study comparing parathyroid hormone-(1–34) versus calcitriol and calcium. J Clin Endocrinol Metab 88:4214–4220PubMedCrossRef Winer KK, Ko CW, Reynolds JC, Dowdy K, Keil M, Peterson D, Gerber LH, McGarvey C, Cutler GB Jr (2003) Long-term treatment of hypoparathyroidism: a randomized controlled study comparing parathyroid hormone-(1–34) versus calcitriol and calcium. J Clin Endocrinol Metab 88:4214–4220PubMedCrossRef
13.
go back to reference Fujiyama K, Kiriyama T, Ito M, Nakata K, Yamashita S, Yokoyama N, Nagataki S (1995) Attenuation of postmenopausal high turnover bone loss in patients with hypoparathyroidism. J Clin Endocrinol Metab 80:2135–2138PubMedCrossRef Fujiyama K, Kiriyama T, Ito M, Nakata K, Yamashita S, Yokoyama N, Nagataki S (1995) Attenuation of postmenopausal high turnover bone loss in patients with hypoparathyroidism. J Clin Endocrinol Metab 80:2135–2138PubMedCrossRef
14.
go back to reference Mazokopakis EE, Starakis IK, Papadomanolaki MG, Batistakis AG, Papadakis JA (2006) Changes of bone mineral density in pre-menopausal women with differentiated thyroid cancer receiving L-thyroxine suppressive therapy. Curr Med Res Opin 22:1369–1373PubMedCrossRef Mazokopakis EE, Starakis IK, Papadomanolaki MG, Batistakis AG, Papadakis JA (2006) Changes of bone mineral density in pre-menopausal women with differentiated thyroid cancer receiving L-thyroxine suppressive therapy. Curr Med Res Opin 22:1369–1373PubMedCrossRef
15.
go back to reference Seeman E, Wahner HW, Offord KP, Kumar R, Johnson WJ, Riggs BL (1982) Differential effects of endocrine dysfunction on the axial and the appendicular skeleton. J Clin Invest 69:1302–1309PubMedCrossRef Seeman E, Wahner HW, Offord KP, Kumar R, Johnson WJ, Riggs BL (1982) Differential effects of endocrine dysfunction on the axial and the appendicular skeleton. J Clin Invest 69:1302–1309PubMedCrossRef
16.
go back to reference Murphy E, Gluer CC, Reid DM, Felsenberg D, Roux C, Eastell R, Williams GR (2010) Thyroid function within the upper normal range is associated with reduced bone mineral density and an increased risk of nonvertebral fractures in healthy euthyroid postmenopausal women. J Clin Endocrinol Metab 95:3173–3181PubMedCrossRef Murphy E, Gluer CC, Reid DM, Felsenberg D, Roux C, Eastell R, Williams GR (2010) Thyroid function within the upper normal range is associated with reduced bone mineral density and an increased risk of nonvertebral fractures in healthy euthyroid postmenopausal women. J Clin Endocrinol Metab 95:3173–3181PubMedCrossRef
17.
go back to reference Rubin MR, Dempster DW, Zhou H, Shane E, Nickolas T, Sliney J Jr, Silverberg SJ, Bilezikian JP (2008) Dynamic and structural properties of the skeleton in hypoparathyroidism. J Bone Miner Res 23:2018–2024PubMedCrossRef Rubin MR, Dempster DW, Zhou H, Shane E, Nickolas T, Sliney J Jr, Silverberg SJ, Bilezikian JP (2008) Dynamic and structural properties of the skeleton in hypoparathyroidism. J Bone Miner Res 23:2018–2024PubMedCrossRef
18.
go back to reference Rubin MR, Sliney J Jr, McMahon DJ, Silverberg SJ, Bilezikian JP (2010) Therapy of hypoparathyroidism with intact parathyroid hormone. Osteoporos Int 21(11):1927–1934PubMedCrossRef Rubin MR, Sliney J Jr, McMahon DJ, Silverberg SJ, Bilezikian JP (2010) Therapy of hypoparathyroidism with intact parathyroid hormone. Osteoporos Int 21(11):1927–1934PubMedCrossRef
19.
go back to reference Rubin MR, Bilezikian JP (2010) Hypoparathyroidism: clinical features, skeletal microstructure and parathyroid hormone replacement. Arq Bras Endocrinol Metabol 54:220–226PubMedCrossRef Rubin MR, Bilezikian JP (2010) Hypoparathyroidism: clinical features, skeletal microstructure and parathyroid hormone replacement. Arq Bras Endocrinol Metabol 54:220–226PubMedCrossRef
Metadata
Title
Low bone turnover and increase of bone mineral density in a premenopausal woman with postoperative hypoparathyroidism and thyroxine suppressive therapy
Authors
K. Amrein
H. P. Dimai
H. Dobnig
A. Fahrleitner-Pammer
Publication date
01-11-2011
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 11/2011
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-010-1441-9

Other articles of this Issue 11/2011

Osteoporosis International 11/2011 Go to the issue