Recovery of parathyroid hormone secretion and function in postoperative hypoparathyroidism: a case series
| Autor: | Dinaz Irani, Mishaela R. Rubin, Laura Anderson, Natalie E. Cusano, James Sliney, John P. Bilezikian, Barbara C. Silva, Aline G. Costa |
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| Rok vydání: | 2013 |
| Předmět: |
Parathyroidectomy
Adult medicine.medical_specialty Hypoparathyroidism Endocrinology Diabetes and Metabolism medicine.medical_treatment Clinical Biochemistry Parathyroid hormone Biochemistry Transplantation Autologous Parathyroid Glands Endocrinology Postoperative Complications Internal medicine medicine Humans Aged Hyperparathyroidism business.industry Biochemistry (medical) Thyroidectomy Recovery of Function Middle Aged medicine.disease Special Features Graves Disease Surgery Transplantation Parathyroid Hormone Parathyroid hormone secretion Female business Primary hyperparathyroidism |
| Zdroj: | The Journal of clinical endocrinology and metabolism. 98(11) |
| ISSN: | 1945-7197 |
| Popis: | Transient and permanent postoperative hypoparathyroidism are recognized complications of neck surgery. Postoperative hypoparathyroidism is usually considered permanent when it persists for 6 months; in rare cases, recovery of hypoparathyroidism through 1 year has been described. Recovery of hypoparathyroidism years after diagnosis has not previously been reported.We report four patients being treated with PTH(1-84) in a research protocol who recovered from postoperative hypoparathyroidism many years after onset.Recovery from hypoparathyroidism was established by: 1) serum calcium and PTH levels within the normal range off PTH(1-84) treatment for at least 1 week; 2) requirement for daily calcium supplementation reduced to ≤1 g; and 3) no supplemental active vitamin D therapy.Hypoparathyroidism developed in three subjects after repeated neck surgery for primary hyperparathyroidism and in one subject after total thyroidectomy for Graves' disease. Parathyroid tissue autotransplant was performed in two of the four subjects. Two had undetectable PTH levels at study entry, whereas the other two subjects had detectable, although low, PTH levels. Hypoparathyroidism had been present for at least 8 years, and in one case for 16 years. The recovery of parathyroid function followed treatment with PTH(1-84) for 36 to 63 months.Although it remains relatively rare, this report documents recovery of long-term postoperative hypoparathyroidism many years after the initial diagnosis. A potential role for exogenous PTH is intriguing with several plausible mechanisms. |
| Databáze: | OpenAIRE |
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