Hypoparathyroidism is the most common and sometimes severe complication after thyroid surgery, because of the close proximity of the parathyroid glands to the thyroid. Major risk factors for postoperatively inadequate PTH production are surgeon’s inexperience, extensive thyroid and neck dissections and re-operations. Identification of at risk patients by means of perioperative serum calcium or PTH measurement facilitates an early diagnosis, a better management of a likely hypocalcemia and short hospital stays. Medical management with calcium and biologically active vitamin D metabolites is effective in correcting calcium homeostasis and preventing symptoms. Hypercalciuria and nephrolithiasis has to be avoided during long-term therapy. Substitutive therapy with teriparatide or full-length PTH has been used in the attempt to decrease daily regimens of calcium and calcitriol, but these drugs are not currently approved for this purpose.
The Parathyroids / Marcocci, Claudio; Cianferotti, Luisella. - ELETTRONICO. - (2012), pp. 227-236. [10.1002/9781118444832.ch25]
The Parathyroids
CIANFEROTTI, LUISELLA
2012
Abstract
Hypoparathyroidism is the most common and sometimes severe complication after thyroid surgery, because of the close proximity of the parathyroid glands to the thyroid. Major risk factors for postoperatively inadequate PTH production are surgeon’s inexperience, extensive thyroid and neck dissections and re-operations. Identification of at risk patients by means of perioperative serum calcium or PTH measurement facilitates an early diagnosis, a better management of a likely hypocalcemia and short hospital stays. Medical management with calcium and biologically active vitamin D metabolites is effective in correcting calcium homeostasis and preventing symptoms. Hypercalciuria and nephrolithiasis has to be avoided during long-term therapy. Substitutive therapy with teriparatide or full-length PTH has been used in the attempt to decrease daily regimens of calcium and calcitriol, but these drugs are not currently approved for this purpose.I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.