Semeraro, A., Kemp, E.H. orcid.org/0000-0002-0313-8916, Pardi, E. et al. (3 more authors) (2020) Late-onset postsurgical hypoparathyroidism following parathyroidectomy for recurrent primary hyperparathyroidism : a case report and literature review. Endocrine, 69 (2). pp. 402-409. ISSN 1355-008X
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 three and six 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.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2020 Springer Nature. This is an author-produced version of a paper subsequently published in Endocrine. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | hyperparathyroidism-jaw tumor syndrome; CDC73; parafibromin; parathyroidectomy |
Dates: |
|
Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 05 May 2020 15:33 |
Last Modified: | 23 Nov 2021 10:58 |
Status: | Published |
Publisher: | Springer (part of Springer Nature) |
Refereed: | Yes |
Identification Number: | 10.1007/s12020-020-02344-y |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:160251 |