Kaderli RM, et al. - Clinicians examined the correlation of intact parathyroid hormone (iPTH) and calcium (Ca) with “temporary hypoparathyroidism” and “hungry bone syndrome” (HBS). The obtained data demonstrate that the necessity for Ca and vitamin D3 substitution cannot be predicted with certainty before POD 5 to 7 without serial laboratory measurements. According to the findings, a routine 8-week course of Ca and vitamin D3 treatment seems reasonable and its necessity should be evaluated in a follow-up study.

Methods

• They assessed potential risk factors for temporary hypoparathyroidism and HBS by taking blood samples before surgery, intraoperatively, at post-operative day (POD) 1, at POD 5 to 7, in postoperative week (POW) 8 and in postoperative month (POM) 6.
• In this study, 43 (10.1%) had temporary hypoparathyroidism and 36 (8.5%) had HBS among 425 patients.

Results

• As per the data, IPTH on POD 1 displayed the highest discriminative ability for temporary hypoparathyroidism (C-index=0.952), but not for HBS.
• It was showed that IPTH was helpful in diagnosing HBS between POD 5 and 7 (C-index=0.708).
• They exhibited evidence that extending the model by including Ca resulted in little improvement of the discriminative ability for temporary hypoparathyroidism (C-index=0.964) and a decreased discriminative ability for HBS (C-index=0.705).
• The data revealed that normal parathyroid metabolism was documented in 139 (32.7%) patients on POD 1 and in 423 (99.5%) six months post-operatively, while 2 (0.5%) patients had persistent hyperparathyroidism, one diagnosed between POD 5 and 7 and another at POW 8.
• They did not find permanent hypoparathyroidism in any patient.