Hypoparathyroidism after total parathyroidectomy plus subcutaneous autotransplantation for secondary...

This retrospective, case-control study was designed to find side effects of hypoparathyroidism after total parathyroidectomy plus autotransplantation.

After successful total parathyroidectomy plus autotransplantation for symptomatic secondary hyperparathyroidism, 19 patients who had intact parathyroid hormone (iPTH) levels <10 pg/ml during the follow-up period of 1 year and 38 patients, who had levels >10 pg/ml, were enrolled as the hypoparathyroid and nonhypoparathyroid groups. Data were collected on etiology, symptoms, serum levels of calcium, phosphate, alkaline phosphatase (Alk-ptase), iPTH, and bone mineral density (BMD) at different sites. Then, 1 week, 3 months, and 1 year after surgery, serum levels of calcium, phosphate, Alk-ptase, and iPTH were measured again. Three months later, symptoms were recorded. One year after surgery, the BMD at different sites was measured again. Patients' daily requirements of calcium carbonate and vitamin D3 were recorded at the mean follow-up of 24 months.

Calcium, phosphate, and iPTH levels decreased significantly 1 week, 3 months, and 1 year after surgery, and Alk-ptase levels increased at 1 week and then decreased significantly 3 months and 1 year after surgery. Symptoms improved significantly 3 months after surgery. The BMD of different sites increased significantly at 1 year. There were no differences between the two groups regarding changes of symptoms, BMD, and calcium, phosphate, and Alk-ptase levels. Hypoparathyroid patients required significantly more calcium carbonate and vitamin D3 than nonhypoparathyroid patients did (P = 0.002).

Even though hypoparathyroid patients require more calcium carbonate and vitamin D3 than nonhypoparathyroid patients do, they do not have any side effects.