Role of Intact Parathormone Levels as Early Predictor of Asymptomatic Hypocalcaemia after Total Thyroidectomy.

ABSTRACT

Asymptomatic hypocalcemia is one of the complications of total thyroidectomy. The symptoms of low calcium levels are sometimes evident only after about 48-72 hours after surgery. Serum calcium levels are not reliable in identifying these patients, because a large number of them are only those with transient hypocalcemia. This study was carried out to evaluate the role of intact parathormone levels in predicting asymptomatic hypocalcemia.METHODSThis cohort study was carried out among 43 patients, who underwent total or completion thyroidectomy. The serum ionized calcium & creatinine levels were measured preoperatively, to rule out pre-operative hypoparathyroidism. Following surgery (one-hour post operatively), the patients’ serum PTH levels and serum ionized calcium levels were measured. Simultaneously, hypocalcemia was clinically evaluated.RESULTSOut of 43 patients, 30 patients had low hypocalcemia (<1.1 mmol/l) one hour postoperatively. The incidence of initial asymptomatic hypocalcaemia post-surgery was 70.5%. All patients with low iPTH, except one, also had hypocalcaemia initially. The patient with normal calcium subsequently had hypocalcaemia at 6 hours.CONCLUSIONSWith the prediction of asymptomatic hypocalcemia in the early post-operative period, it is possible to start timely treatment and thereby prevent the complications of hypocalcemia.