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Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

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Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
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Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
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Graves Disease II: Pathophysiology01:24

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Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...
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Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
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Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
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Factors affecting hypocalcaemia following total thyroidectomy: a prospective study.

Bunyami Ozogul1, Mufide Nuran Akcay1, Gungor Akcay2

  • 1Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

The Eurasian Journal of Medicine
|January 23, 2015
PubMed
Summary

Hypocalcaemia after thyroidectomy is linked to female gender, thyroid cancer, nodule size, parathyroid injury, and vitamin D deficiency. These factors indicate hypocalcaemia is a complex, multifactorial complication.

Keywords:
Thyroidectomyhypocalcaemia

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Surgery

Background:

  • Hypocalcaemia is a significant complication following thyroidectomy.
  • Identifying predictive factors for hypocalcaemia is crucial for clinical management.

Purpose of the Study:

  • To investigate factors associated with the development of hypocalcaemia after thyroidectomy.
  • To analyze the relationship between various patient and surgical parameters and postoperative hypocalcaemia.

Main Methods:

  • Prospective study of 196 patients undergoing thyroidectomy.
  • Evaluation of patient demographics, preoperative diagnosis, hormonal status, surgical details (operative time, surgeon, parathyroid injury/autotransplantation, bleeding), and preoperative anti-thyroid drug use.
  • Postoperative assessment of serum calcium, phosphorus, and parathyroid hormone levels.
  • Statistical analysis using chi-square test and logistic regression.

Main Results:

  • Hypocalcaemia occurred in 47 out of 196 patients.
  • Factors associated with hypocalcaemia included female gender, preoperative diagnosis of thyroid cancer or toxic nodular goiter, nodule size less than 3cm, parathyroid gland injury, parathyroid gland autotransplantation, and low vitamin D levels.
  • Logistic regression identified these factors as significant predictors.

Conclusions:

  • Postoperative hypocalcaemia after thyroidectomy is multifactorial.
  • Key associated factors include gender, preoperative diagnosis, parathyroid gland injury, nodule size, and vitamin D deficiency.
  • A singular etiological factor is insufficient to explain the occurrence of hypocalcaemia.