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ORIGINAL RESEARCH ARTICLE
Year : 2017  |  Volume : 2  |  Issue : 1  |  Page : 84-91

Post-thyroidectomy permanent hypocalcemia and hypoparathyroidism: frequency and risk factors


1 Consultant endocrinologist, Alhawary General Hospital. Department of Medicine, Faculty of Medicine, University of Benghazi, Libya
2 Jamhorya hospital-Benghazi, Department of Medicine, Faculty of Medicine, University of Benghazi, Libya

Correspondence Address:
K D Alsaeiti
Jamhorya hospital-Benghazi, Department of Medicine, Faculty of Medicine, University of Benghazi
Libya
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Source of Support: None, Conflict of Interest: None


DOI: 10.21502/limuj.011.02.2017

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Background: Hypoparathyroidism is the most common complication after thyroidectomy and the main reason for frequent outpatients' visits; however, there is a poor understanding of its outcomes, and no clear follow-up strategies are available. We aimed to evaluate the frequency and risk factors of post-thyroidectomy hypocalcemia hypoparathyroidism in Libyan patients. Methods: A case series study was conducted. The serum calcium and parathyroid hormone level (PTH) were measured at least 8 months post thyroidectomy. Results: 124 patients were reviewed in this study; 19 (15.3 %) were males and 105 (84.7 %) were females. 30.6 % of males and 13.7% of females developed hypocalcemia and hypoparathyroidism. Total thyroidectomy (TT) was performed in 62.9 % of all patients, while 24.2% of all patients underwent near total thyroidectomy (NTT). 12.1% of all patients underwent bilateral subtotal thyroidectomy (BST) and 1 patient underwent hemi thyroidectomy (0.8%). The risk of hypocalcemia was higher in patients with malignant thyroid disease in comparison to benign thyroids (45.8 % vs. 27% of patients). Papillary thyroid carcinoma (PTC) was the most common cause of both hypocalcemia and hypoparathyroidism (45.5% for both) followed by Graves' disease (22.2% and 14.8% for hypocalcemia and hypoparathyroidism respectively). Hypocalcemia and hypoparathyroidism were more frequent in patients who underwent TT (19.2%), as compared to patients who underwent NTT (6.6 %). Among nine patients who were operated on twice, three patients had hypocalcemia, and two of them were found to be hypoparathyroid; one case is diagnosed with Graves' disease, while the other was diagnosed as PTC. Conclusion: Total thyroidectomy, and re-operation are associated with increased prevalence of permanent hypocalcemia and hypoparathyroidism when compared to less extensive thyroid resection modes.


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