Late-onset postsurgical hypoparathyroidism following parathyroidectomy for recurrent primary hyperparathyroidism: a case report and literature review.
Endocrine
; 69(2): 402-409, 2020 08.
Article
in En
| MEDLINE
| ID: mdl-32435983
ABSTRACT
PURPOSE:
Previously in 1987, a 21-year-old male was diagnosed with primary hyperparathyroidism (PHPT) when a right inferior parathyroid adenoma was removed. PHPT recurred after 3 and 6 years and on both occasions was cured by resection of parathyroid adenomas. At 52 years of age, the patient developed a late-onset hypoparathyroidism (HP), even though postsurgical HP typically occurs as a transient or permanent form soon after neck surgery. The purpose of this work was to report the follow-up of the patient and to review prior cases of late-onset postsurgical HP.METHODS:
Prior cases of late-onset postsurgical HP were searched and reviewed focusing on clinical and biochemical features.RESULTS:
The patient's asymptomatic hypocalcemia with total serum calcium at 8.2 mg/dL was initially documented in September 2018; PTH was inappropriately low at 15 ng/mL. In February 2020, a mild hypocalcemia was confirmed with low-normal PTH at 15 ng/mL. Autoimmune and familial causes of HP were ruled out including the presence of stimulating autoantibodies against calcium-sensing receptor. Instead, a progressive damage or atrophy of the parathyroid gland(s) ensuing years after surgery is believed to have led to the patient's hypocalcemia. All 19 previously reported cases of late-onset postsurgical HP occurred after thyroid surgery, with no examples of the condition being found following parathyroidectomy.CONCLUSIONS:
The case highlights the rare occurrence of late-onset postsurgical HP in a patient who had had multiple parathyroidectomies for PHPT. Thus, monitoring serum calcium, phosphate, and PTH during follow-up of such patients is recommended.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Parathyroid Neoplasms
/
Hyperparathyroidism, Primary
/
Hypoparathyroidism
Limits:
Adult
/
Humans
/
Male
Language:
En
Journal:
Endocrine
Journal subject:
ENDOCRINOLOGIA
Year:
2020
Document type:
Article
Affiliation country:
Italy