Postoperative hungry bone syndrome in primary hyperparathyroidism: A case report

Area of Science:

• Endocrinology
• Surgical Oncology
• Nephrology

Background:

• Hungry bone syndrome (HBS) is an underdiagnosed cause of severe hypocalcemia post-parathyroidectomy (PTX).
• It occurs in patients with high bone turnover, where decreased parathyroid hormone leads to excessive calcium resorption.
• Associated hypophosphatemia and hypomagnesemia can occur.

Purpose of the Study:

• To present a case of HBS following PTX for a parathyroid adenoma.
• To summarize predictors and perioperative management strategies for HBS.

Main Methods:

• A 57-year-old woman with symptomatic hyperparathyroidism underwent PTX for a parathyroid adenoma.
• Postoperative HBS was diagnosed on day 3 and managed with calcium supplementation and other interventions.
• The patient's condition resolved over 9 days, with discharge on day 13.

Main Results:

• The patient experienced a 9-day episode of HBS post-PTX.
• Successful management with calcium supplementation and pharmacological interventions led to normalization of parameters.
• The patient was discharged on postoperative day 13.

Conclusions:

• HBS is a critical consideration in patients with primary hyperparathyroidism undergoing PTX.
• Identifying predictors and optimizing perioperative management can mitigate HBS severity and duration.
• This case underscores the importance of prompt diagnosis and treatment of HBS.