Postsurgical Hypoparathyroidism: A Systematic Review

In Vivo. 2016 May-Jun;30(3):171-9.

Abstract

This article reviews epidemiology, risk factors and treatment modalities of postsurgical hypoparathyroidism (PHypo). PHypo occurs after total thyroidectomy due to injury of parathyroid glands and/or their blood supply or after parathyroidectomy. PHypo results in hypocalcemia because parathyroid hormone (PTH) secretion is impaired and cannot mobilize calcium from bone, reabsorb calcium from the distal nephron and stimulate renal 1α-hydroxylase activity. It usually appears in the first days after surgery and it can be symptomatic or asymptomatic. Risk factors are low level of intraoperative PTH and presence of parathyroid gland in the pathological specimen. Patients usually present with paresthesia, cramps or tetany, but the disorder may also manifest acutely with seizures, bronchospasm, laryngospasm or cardiac rhythm disturbances. Standard treatment is vitamin D analogues and calcium supplementation.

Keywords: Postsurgical hypoparathyroidism; parathormone; parathyroid glands; review; thyroidectomy.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Calcium / therapeutic use
  • Humans
  • Hypoparathyroidism / diagnosis*
  • Hypoparathyroidism / drug therapy
  • Hypoparathyroidism / etiology
  • Parathyroid Glands / metabolism*
  • Parathyroid Glands / pathology
  • Parathyroid Hormone / metabolism*
  • Parathyroidectomy / adverse effects
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology
  • Thyroidectomy / adverse effects
  • Vitamin D / therapeutic use
  • Vitamins / therapeutic use

Substances

  • Parathyroid Hormone
  • Vitamins
  • Vitamin D
  • Calcium