AI Article Synopsis

  • This study investigates how parathyroid hormone (PTH) and calcium levels behave in patients with Graves' disease who develop secondary hyperparathyroidism (SHPT) after thyroid surgery.
  • Researchers compared two groups: one with normal PTH levels and another with elevated levels, finding that those with SHPT had significantly lower calcium levels before surgery.
  • The findings suggest that patients with SHPT are more likely to experience a steep drop in PTH after surgery, which, when paired with their already low calcium levels, raises their risk of postoperative hypocalcemia.

Article Abstract

Purpose: To investigate the parathyroid function and calcium (Ca) levels in the secondary hyperparathyroidism (SHPT) state in patients with Graves' disease.

Methods: We examined 31 consecutive patients with Graves' disease without chronic kidney disease, who were treated with total thyroidectomy. The patients were divided into a normal parathyroid hormone (PTH) group (NPTH group; n = 19) with a PTH level ≤ 65 pg/mL, and a secondary hyperparathyroidism group (SHPT group; n = 12), with a PTH level > 65 pg/mL. The PTH and Ca-related parameters were examined and the risk factors for postoperative hypocalcemia were analyzed.

Results: The preoperative Ca level was significantly lower (2.24 ± 0.06 vs. 2.31 ± 0.07 mmol/L, p < 0.05) in the SHPT group than in the NPTH group. The reduction in PTH, 1,25-dihydroxyvitamin D (1,25(OH)2D), and Ca levels from the preoperative day to the next morning was significantly greater in the SHPT group than in the NPTH group (p < 0.05). When intraoperative factors were included, the decrease in the PTH level alone was significant. SHPT was a significant factor in determining the extent of PTH reduction.

Conclusions: Hyperfunctioning parathyroid glands in the SHPT state were more susceptible to postoperative PTH reduction, which, combined with low preoperative Ca levels, increased the risk of postoperative hypocalcemia in patients with Graves' disease.

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Source
http://dx.doi.org/10.1007/s00595-024-02848-4DOI Listing

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