[Two successful pregnancies after total thyroidectomy and parathyroidectomy]

A 23-year-old woman presented with a thyroid mass and total thyroidectomy was performed. Histological examination revealed papillary thyroid carcinoma. In the postoperative period severe hypocalcaemia due to permanent hypoparathyroidism developed. After postoperative telecobalt irradiation and substitutional hormone therapy (200-400 micrograms/day levothyroxin and 0.5-1.5 micrograms/day calcitriol) the patient had two successful pregnancies. The adaptation of the two mature newborns was without any complication. During pregnancy, the patient was treated with increased doses of levothyroxine and calcitriol. During lactation, the hormone substitution doses were decreased to those used in non pregnant stage. The authors conclude that the successful pregnancies were largely attributable to adequate dose-adjustments of levothyroxine and calcitriol based on frequent measurements of thyroid hormones and serum calcium.