Delayed Calcium Normalization after Successful Parathyroidectomy in Primary Hyperparathyroidism
Introduction. Parathyroidectomy is the curative treatment option in primary hyperparathyroidism (PHPT). The decrease of parathormone (PTH) by 50% or more from levels prior to surgery after excision predicts successful parathyroidectomy. Serum calcium is expected to return to normal within 24–72 hour...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2021/5556977 |
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| author | Iván Emilio de la Cruz Rodríguez Elsy Sarahí García Montesinos María Fernanda Rodríguez-Delgado Guadalupe Vargas Ortega Lourdes Balcázar Hernández Victoria Mendoza Zubieta Victor Hernández Avendaño Baldomero González Virla |
| author_facet | Iván Emilio de la Cruz Rodríguez Elsy Sarahí García Montesinos María Fernanda Rodríguez-Delgado Guadalupe Vargas Ortega Lourdes Balcázar Hernández Victoria Mendoza Zubieta Victor Hernández Avendaño Baldomero González Virla |
| author_sort | Iván Emilio de la Cruz Rodríguez |
| collection | DOAJ |
| description | Introduction. Parathyroidectomy is the curative treatment option in primary hyperparathyroidism (PHPT). The decrease of parathormone (PTH) by 50% or more from levels prior to surgery after excision predicts successful parathyroidectomy. Serum calcium is expected to return to normal within 24–72 hours after the surgery; however, nearly 10% have transient, persistent postoperative hypercalcemia. We present a case report of delayed calcium normalization after successful parathyroidectomy in a 38-year-old patient with PHPT. Methods. Parathyroidectomy was performed, with evidence of a decrease in PTH levels of more than 50% in the first 24 hours postoperatively compared to presurgical PTH; however, despite curative parathyroidectomy, a delayed calcium normalization was evidenced, with hypercalcemia persistence up to 120 hours postoperatively. Results. After the first month postoperatively, serum calcium remained normal. In conclusion, approximately 10% of patients with curative parathyroidectomy have transient, persistent postoperative hypercalcemia, which is more likely to occur in patients with higher preoperative serum calcium and PTH levels. Conclusion. Persistent hypercalcemia after the first month postoperatively is related with persistent PHPT, highlighting the importance of calcium monitoring after parathyroidectomy to predict short-term, medium-term, and long-term outcomes and prognosis. |
| format | Article |
| id | doaj-art-62b53074747b4fd58685c37ab61eca3a |
| institution | Kabale University |
| issn | 2090-6501 2090-651X |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Endocrinology |
| spelling | doaj-art-62b53074747b4fd58685c37ab61eca3a2025-02-03T06:07:39ZengWileyCase Reports in Endocrinology2090-65012090-651X2021-01-01202110.1155/2021/55569775556977Delayed Calcium Normalization after Successful Parathyroidectomy in Primary HyperparathyroidismIván Emilio de la Cruz Rodríguez0Elsy Sarahí García Montesinos1María Fernanda Rodríguez-Delgado2Guadalupe Vargas Ortega3Lourdes Balcázar Hernández4Victoria Mendoza Zubieta5Victor Hernández Avendaño6Baldomero González Virla7Endocrinology Department. Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City 067200, MexicoEndocrinology Department. Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City 067200, MexicoFaculty of Medicine, Universidad Nacional Autónoma de México, Coordinacion de Servicios a la Comunidad, Programa Comunidad Saludable-Comunidad Solidaria, Mexico City, MexicoEndocrinology Department. Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City 067200, MexicoEndocrinology Department. Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City 067200, MexicoEndocrinology Department. Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City 067200, MexicoEndocrinology Department. Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City 067200, MexicoEndocrinology Department. Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City 067200, MexicoIntroduction. Parathyroidectomy is the curative treatment option in primary hyperparathyroidism (PHPT). The decrease of parathormone (PTH) by 50% or more from levels prior to surgery after excision predicts successful parathyroidectomy. Serum calcium is expected to return to normal within 24–72 hours after the surgery; however, nearly 10% have transient, persistent postoperative hypercalcemia. We present a case report of delayed calcium normalization after successful parathyroidectomy in a 38-year-old patient with PHPT. Methods. Parathyroidectomy was performed, with evidence of a decrease in PTH levels of more than 50% in the first 24 hours postoperatively compared to presurgical PTH; however, despite curative parathyroidectomy, a delayed calcium normalization was evidenced, with hypercalcemia persistence up to 120 hours postoperatively. Results. After the first month postoperatively, serum calcium remained normal. In conclusion, approximately 10% of patients with curative parathyroidectomy have transient, persistent postoperative hypercalcemia, which is more likely to occur in patients with higher preoperative serum calcium and PTH levels. Conclusion. Persistent hypercalcemia after the first month postoperatively is related with persistent PHPT, highlighting the importance of calcium monitoring after parathyroidectomy to predict short-term, medium-term, and long-term outcomes and prognosis.http://dx.doi.org/10.1155/2021/5556977 |
| spellingShingle | Iván Emilio de la Cruz Rodríguez Elsy Sarahí García Montesinos María Fernanda Rodríguez-Delgado Guadalupe Vargas Ortega Lourdes Balcázar Hernández Victoria Mendoza Zubieta Victor Hernández Avendaño Baldomero González Virla Delayed Calcium Normalization after Successful Parathyroidectomy in Primary Hyperparathyroidism Case Reports in Endocrinology |
| title | Delayed Calcium Normalization after Successful Parathyroidectomy in Primary Hyperparathyroidism |
| title_full | Delayed Calcium Normalization after Successful Parathyroidectomy in Primary Hyperparathyroidism |
| title_fullStr | Delayed Calcium Normalization after Successful Parathyroidectomy in Primary Hyperparathyroidism |
| title_full_unstemmed | Delayed Calcium Normalization after Successful Parathyroidectomy in Primary Hyperparathyroidism |
| title_short | Delayed Calcium Normalization after Successful Parathyroidectomy in Primary Hyperparathyroidism |
| title_sort | delayed calcium normalization after successful parathyroidectomy in primary hyperparathyroidism |
| url | http://dx.doi.org/10.1155/2021/5556977 |
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