Hypocalcaemia following total thyroidectomy: early post-operative parathyroid hormone assay as a risk stratification and management tool. Issue 3 (24th March 2014)

• Record Type: Journal Article
• Authors: Islam, S; Al Maqbali, T; Howe, D; Campbell, J
• Is Part Of: Journal of laryngology & otology. Volume 128:Issue 3(2014)
• Page Start: 274
• Page End: 278
• Publication Date: 2014-03-24
• Subjects: Otolaryngology -- Periodicals; 617.51
• DOI: 10.1017/S0022215113002600
• Languages: English
• ISSNs: 0022-2151

Abstract

<abstract abstract-type="normal"> <title>Abstract</title> <sec id="sec1"> <title>Objective:</title> <p>To develop a practical, efficient and predictive algorithm to manage potential or actual post-operative hypocalcaemia after complete thyroidectomy, using a single post-operative parathyroid hormone assay.</p> </sec> <sec id="sec2"> <title>Methods:</title> <p>This paper reports a prospective study of 59 patients who underwent total or completion thyroidectomy over a period of 24 months. Parathyroid hormone levels were checked post-operatively on the day of surgery, and all patients were evaluated for hypocalcaemia both clinically and biochemically with serial corrected calcium measurements.</p> </sec> <sec id="sec3"> <title>Results:</title> <p>No patient with an early post-operative parathyroid hormone level of 23 ng/l or more (i.e. approximately twice the lower limit of the normal range) developed hypocalcaemia. All the patients who initially had post-operative hypocalcaemia but had an early parathyroid hormone level of 8 ng/l or more (i.e. approximately two-thirds of the lower limit of the normal range) had complete resolution of their hypocalcaemia within three months.</p> </sec> <sec id="sec4"> <title>Conclusion:</title> <p>Early post-operative parathyroid hormone measurement can reliably predict patients at risk of post-thyroidectomy hypocalcaemia, and predict those patients expected to recover from temporary hypocalcaemia. A suggested post-operative management algorithm is presented.</p> </sec> </abstract>