CLINICAL FEATURES, DIAGNOSIS, AND OPTIMIZATION OF MANAGEMENT IN POST-THYROIDECTOMY HYPOPARATHYROIDISM

Аннотация

Post-thyroidectomy hypoparathyroidism (PH) is a common complication of thyroid surgery, often causing hypocalcemia and reducing quality of life. This study evaluated 60 patients undergoing thyroidectomy for incidence, clinical features, biochemical changes, and treatment outcomes of PH. Transient PH occurred in 18 patients (30%), and permanent PH in 5 patients (8.3%). The most frequent clinical manifestations were paresthesia (36.7%), muscle cramps (25%), tetany (6.7%), and positive Chvostek or Trousseau signs (16.7%). Mean serum calcium decreased from 9.3 ± 0.4 mg/dL preoperatively to 7.2 ± 0.6 mg/dL at 24 hours postoperatively (p < 0.01), while mean PTH dropped from 48 ± 15 pg/mL to 12 ± 6 pg/mL at 12 hours postoperatively in affected patients. Total thyroidectomy was associated with a higher PH rate (35%) compared to subtotal thyroidectomy (15%), and preservation of parathyroid glands significantly reduced hypocalcemia risk (p < 0.05). Intravenous calcium corrected acute hypocalcemia in 90% of patients within 24–48 hours, and oral calcium with active vitamin D maintained normocalcemia in 85% at 3 months. Individualized therapy reduced recurrent symptoms and hospital readmissions. Early diagnosis, careful surgical technique, and tailored postoperative management are crucial to optimize outcomes and prevent complications in PH patients.