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Erschienen in: Endocrine 2/2020

21.05.2020 | Original Article

Late-onset postsurgical hypoparathyroidism following parathyroidectomy for recurrent primary hyperparathyroidism: a case report and literature review

verfasst von: Antonella Semeraro, Elizabeth Helen Kemp, Elena Pardi, Agostino Di Certo, Claudio Marcocci, Filomena Cetani

Erschienen in: Endocrine | Ausgabe 2/2020

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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.
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Metadaten
Titel
Late-onset postsurgical hypoparathyroidism following parathyroidectomy for recurrent primary hyperparathyroidism: a case report and literature review
verfasst von
Antonella Semeraro
Elizabeth Helen Kemp
Elena Pardi
Agostino Di Certo
Claudio Marcocci
Filomena Cetani
Publikationsdatum
21.05.2020
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 2/2020
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-020-02344-y

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