Abstract

BERMUDEZ, Valmore et al. Appropriate treatment of post-surgical hypoparathyroidism: pathophysiological basis for therapy. AVFT [online]. 2015, vol.34, n.2, pp.27-30. ISSN 0798-0264.

Introduction: Post-surgical hypoparathryoidism and hypocalcemia are particularly relevant events due to paramount epidemiological and clinical importance. Case Report: Female, 65-year old patient who 2 days after undergoing total thyroidectomy presents progressive dyspnea, dysphagia and parestesia in hands, legs, periorbitary and perioral regions; as well as muscular spams in hands and lips with increasing severity. After clinical evaluation, she is administered intravenous calcium gluconate, improving symptomatology. PTH: 3.00 pg/mL, Serum calcium: 7.69 mg/ dL. This episode repeated in 4 subsequent occasions before she was started on 6 g calcium citrate and 15μg of calciferol daily. This scheme was followed during 9 months without satisfactory improvement, prompting referral to our institution, where indications are changed to 5g of calcium citrate and 0.25μg calcitriol twice a day. Calcium dosage was adjusted to 2g throughout 2 weeks. Symptoms were attenuated during the first week on this plan and totally disappeared by the second week. Discussion: This case highlighted the importance of accurate knowledge of Vitamin D analogue physiology and pharmacology in order to offer adequate care to HPT patients.

Keywords : Hypocalcemia; Hypoparathyroidism; Vitamin D analogues; m metabolism.