Transient Hypocalcemia after Thyroidectomy

Hong, Ki Hwan; Cho, Yoon Sung; Kim, In

Abstract

BACKGROUND AND OBJECTIVES
We reviewed the records of 466 patients who had thyroid surgery. Transient hypocalcemia was found in 50 patients (10.7%). The post-thyroidectomy hypocalcemia is a multifactorial phenomenon. We suppose that the causes of transient hypocalcemia after thyroid surgery were hypoparathyroidism and nonspecific hemodilution. So, we will try to demonstrate the causes.
MATERIALS AND METHODS
30 patients recently undergoing thyroid surgery were prospectively followed. Serum concentrations of total calcium, ionized calcium, albumin, and parathyroid hormone were determined just before and 6, 24, 48, 72, and 96 hours after surgery.
RESULTS
In the whole population, there was a statistically significant decrease of parathyroid hormone, total calcium, and albumin when compared with the preoperative levels. But ionized calcium was not changed. The parathyroid hormone, total calcium and ionized calcium levels were significantly lower after total thyroidectomy than after hemithyroidectomy. But after hemithyroidectomy, ionized calcium, total calcium and parathyroid hormone levels were decreased to the lower normal limit.
CONCLUSION
Despite careful preservation of the parathyroid glands and their blood supply, thyroidectomy was often followed by transient hypocalcemia, the determinants of which are hypoparathyroidism and nonspecific hemodilution.