Late Recovery of Parathyroid Function after Total Thyroidectomy in Children and Adults: Is There a Difference?
| Autor: | Tarek E. Abdel-Aziz, Joan Sancho-Insenser, Antonio Sitges-Serra, Mechteld C. de Jong, Colin R. Butler, Richard Hewitt, Tom R. Kurzawinski, Caroline Brain, Virginia Rozalén García, Leyre Lorente-Poch |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Adolescent Hypoparathyroidism Endocrinology Diabetes and Metabolism Late recovery Gastroenterology Cohort Studies Postoperative Complications Endocrinology Recovery rate Internal medicine London medicine Humans Child Adverse effect Pathological Aged Aged 80 and over Total thyroidectomy Vitamin d supplementation business.industry Age Factors Infant Recovery of Function Middle Aged medicine.disease Spain Child Preschool Pediatrics Perinatology and Child Health Thyroidectomy Female business |
| Zdroj: | Hormone Research in Paediatrics. 93:539-547 |
| ISSN: | 1663-2826 1663-2818 |
| Popis: | Background: Parathyroid failure after total thyroidectomy is the commonest adverse event amongst both children and adults. The phenomenon of late recovery of parathyroid function, especially in young patients with persistent hypoparathyroidism, is not well understood. This study investigated differences in rates of parathyroid recovery in children and adults and factors influencing this. Methods: A joint dual-centre database of patients who underwent a total thyroidectomy between 1998 and 2018 was searched for patients with persistent hypoparathyroidism, defined as dependence on oral calcium and vitamin D supplementation at 6 months. Demographic, surgical, pathological, and biochemical data were collected and analysed. Parathyroid Glands Remaining in Situ (PGRIS) score was calculated. Results: Out of 960 patients who had total thyroidectomy, 94 (9.8%) had persistent hypoparathyroidism at 6 months, 23 (24.5%) children with a median [range] age 10 [0–17], and 71 (75.5%) adults aged 55 [25–82] years, respectively. Both groups were comparable regarding sex, indication, extent of surgery, and PGRIS score. After a median follow-up of 20 months, the parathyroid recovery rate was identical for children and adults (11 [47.8%] vs. 34 [47.9%]; p = 0.92). Sex, extent, and indication for surgery had no effect on recovery (all p > 0.05). PGRIS score = 4 (HR = 0.48) and serum calcium >2.25 mmol/L (HR = 0.24) at 1 month were associated with a decreased risk of persistent hypoparathyroidism on multivariate analysis (p < 0.05). Conclusion: Almost half of patients recovered from persistent hypoparathyroidism after 6 months; therefore, the term persistent instead of permanent hypoparathyroidism should be used. Recovery rates of parathyroid function in children and adults were similar. Regardless of age, predictive factors for recovery were PGRIS score = 4 and a serum calcium >2.25 mmol/L at 1 month. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|