ABSTRACT
BACKGROUND AND OBJECTIVES: Hypocalcemia is the most frequent complication following total thyroidectomy. This prospective study examines the predictive value of parathyroid hormone (PTH) levels measured 1 hour after surgery. MATERIALS AND METHOD: Twenty-four patients underwent total or near-total thyroidectomy for benign or malignant thyroid tumor in one year. Serum calcium and PTH levels were measured preoperatively and at 1 hour after surgery. RESULTS: All patients were classified into three groups according to hypocalcemic symptoms and postoperative serum calcium levels. A total of 6 (25%) patients were found with hypocalcemia, as demonstrated by clinical and laboratory findings. PTH levels at 1 hour were below normal level (100%) for 6 of the 6 symptomatic hypocalcemia patients, 5 (45%) of the 11 biochemical hypocalcemia patients, and in 1 (14%) of 7 normocalcemic patients (p=0.002). The sensitivity and specificity of postoperative 1 hour PTH assessment to predict symptomatic hypocalcemia were 100% and 66%. The positive and negative predictive rate of postoperative 1 hour PTH assessment to predict symptomatic hypocalcemia were 50% and 100%. CONCLUSION: Parathyroid gland insufficiency is the main determinant of transient hypocalcemia after bilateral thyroid surgery. Low PTH level at 1 hour after surgery is therefore a feasible predictor of postoperative symptomatic hypocalcemia and permanent hypoparathyroidism.
Subject(s)
Humans , Calcium , Hypocalcemia , Hypoparathyroidism , Parathyroid Glands , Parathyroid Hormone , Prospective Studies , Sensitivity and Specificity , Thyroid Gland , ThyroidectomyABSTRACT
950 mg/d) group was significantly higher than those in median or low calcium intake group,among girls with BB genotype. However,such significant effect was not detected among girls with b allele. Conclusion:The PTH BstBⅠ polymorphism has significant interaction effect with calcium intake on bone mass accretion in Chinese adolescent girls. High calcium intake would be beneficial to gain higher bone mass accretion for girls with BB genotype than those with b allele.