Korean J Nephrol.  2005 Jul;24(4):654-659.

A Case of Hungry Bone Syndrome after Parathyroidectomy

• Kim TH
• Hong YK
• Gil HW
• Yang JO
• Lee EY
• Hong SY
• Yang SH

Abstract

Patients with secondary hyperparathyroidism usually present with a history of underlying disease such as chronic renal failure. Tertiary hyperparathyroidism usually exists in situations of secondary hyperparathyroidism. It occurs when parathyroid hyperplasia becomes so severe that removal of the underlying cause does not eliminate the stimulus for PTH secretion and hypertrophic chief cells become autonomous. Surgical parathyroidectomy sould be considered in patients with uncontrolled hyperparathyroidism. Hungry bone syndrome is known to be developed due to extensive remineralization of skeleton after parathyroidectomy. It is characterized by prolonged symptomatic hypocalcemia, as a complication of the parathyroidectomy for hyperthyroidism. We have experienced a female patient with hypercalcemia, who had been on maintenance hemodialysis for 15 years. She had elevated intact PTH and alkaline phosphatase. We decided parathyroidectomy because of uncontrolled hyperthyroidism despite of medical treatment. A few weeks after the operation she developed a muscle pain and arthralgia, which were found to be due to severe hypocalcaemia. Calcium suppletion led to normalization of the serum calcium level. she was discharged from the hospital in good condition after calcium supplement. We report a case of hungry bone syndrome developed after parathyroidectomy in this patient.

Keyword

Hungry bone syndrome; Tertiary hyperparathyroidism; Chronic renal failure

MeSH Terms

Alkaline Phosphatase
Arthralgia
Calcium
Female
Humans
Hypercalcemia
Hyperparathyroidism
Hyperparathyroidism, Secondary
Hyperplasia
Hyperthyroidism
Hypocalcemia
Kidney Failure, Chronic
Myalgia
Parathyroidectomy*
Renal Dialysis
Skeleton
Alkaline Phosphatase
Calcium