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Hemithyroidectomy: Long-term effects on parathyroid function-preliminary report

Lindblom, Pia LU ; Westerdahl, Johan LU and Bergenfelz, Anders LU (2001) In World Journal of Surgery 25(9). p.1155-1159
Abstract
Early hypocalcemia after thyroid surgery has frequently been reported, whereas data regarding long-term effects on calcium homeostasis are scarce. We have previously studied patients after hemithyroidectomy with an oral calcium load test and found normal parathyroid hormone (PTH) suppression. However, the 1,25-dihydroxyvitamin D concentration was decreased and the phosphate concentration increased, implying parathyroid insufficiency. We therefore proceeded to investigate PTH secretion and suppression in 10 euthyroid patients subjected to hemithyroidectomy due to benign thyroid disease before and at 1 year after surgery. In addition, biochemical variables known to influence calcium homeostasis were analyzed. Basal, maximal, and total PTH... (More)
Early hypocalcemia after thyroid surgery has frequently been reported, whereas data regarding long-term effects on calcium homeostasis are scarce. We have previously studied patients after hemithyroidectomy with an oral calcium load test and found normal parathyroid hormone (PTH) suppression. However, the 1,25-dihydroxyvitamin D concentration was decreased and the phosphate concentration increased, implying parathyroid insufficiency. We therefore proceeded to investigate PTH secretion and suppression in 10 euthyroid patients subjected to hemithyroidectomy due to benign thyroid disease before and at 1 year after surgery. In addition, biochemical variables known to influence calcium homeostasis were analyzed. Basal, maximal, and total PTH secretion were unaltered 1 year postoperatively. However, maximal PTH secretion was reached at a lower serum level of ionized calcium, and there was a tendency toward increased parathyroid sensitivity to ionized calcium. Furthermore, compared to preoperatively, total serum calcium, 1,25-dihydroxyvitamin D, and free thyroxine (T-4) concentrations were decreased at follow-up. Total serum calcium and 1,25-dihydoxyvitamin D concentrations were decreased 1 year after hemithyroidectomy. These changes were not due to parathyroid insufficiency. Instead, our results imply increased parathyroid sensitivity to calcium and possibly reduced peripheral sensitivity to PTH. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
World Journal of Surgery
volume
25
issue
9
pages
1155 - 1159
publisher
Springer
external identifiers
  • wos:000170934500011
  • scopus:0034848910
ISSN
1432-2323
language
English
LU publication?
yes
id
75479d2e-918a-4ee7-851a-46ed43e14154 (old id 1118916)
date added to LUP
2008-08-27 10:41:57
date last changed
2018-05-29 10:33:10
@article{75479d2e-918a-4ee7-851a-46ed43e14154,
  abstract     = {Early hypocalcemia after thyroid surgery has frequently been reported, whereas data regarding long-term effects on calcium homeostasis are scarce. We have previously studied patients after hemithyroidectomy with an oral calcium load test and found normal parathyroid hormone (PTH) suppression. However, the 1,25-dihydroxyvitamin D concentration was decreased and the phosphate concentration increased, implying parathyroid insufficiency. We therefore proceeded to investigate PTH secretion and suppression in 10 euthyroid patients subjected to hemithyroidectomy due to benign thyroid disease before and at 1 year after surgery. In addition, biochemical variables known to influence calcium homeostasis were analyzed. Basal, maximal, and total PTH secretion were unaltered 1 year postoperatively. However, maximal PTH secretion was reached at a lower serum level of ionized calcium, and there was a tendency toward increased parathyroid sensitivity to ionized calcium. Furthermore, compared to preoperatively, total serum calcium, 1,25-dihydroxyvitamin D, and free thyroxine (T-4) concentrations were decreased at follow-up. Total serum calcium and 1,25-dihydoxyvitamin D concentrations were decreased 1 year after hemithyroidectomy. These changes were not due to parathyroid insufficiency. Instead, our results imply increased parathyroid sensitivity to calcium and possibly reduced peripheral sensitivity to PTH.},
  author       = {Lindblom, Pia and Westerdahl, Johan and Bergenfelz, Anders},
  issn         = {1432-2323},
  language     = {eng},
  number       = {9},
  pages        = {1155--1159},
  publisher    = {Springer},
  series       = {World Journal of Surgery},
  title        = {Hemithyroidectomy: Long-term effects on parathyroid function-preliminary report},
  volume       = {25},
  year         = {2001},
}