American Thyroid Association Statement on Postoperative Hypoparathyroidism: Diagnosis, Prevention, and Management in Adults

• DOI: 10.1089/thy.2017.0309
• Publication Date: 2018-05-31T11:37:37Z
• Authors: Lisa A. Orloff; Sam M. Wiseman; Victor J. Bernet; Thomas J. Fahey; Ashok R. Shaha; Maisie L. Shindo; Samuel K. Snyder; Brendan C. Stack; John B. Sunwoo; Marilene B. Wang
• Keywords: Hypoparathyroidism

Hypoparathyroidism (hypoPT) is the most common complication following bilateral thyroid operations. Thyroid surgeons must employ strategies for minimizing and preventing post-thyroidectomy hypoPT. The objective of this American Association Surgical Affairs Committee Statement to provide an overview its diagnosis, prevention, treatment.HypoPT occurs when a low intact parathyroid hormone (PTH) level accompanied by hypocalcemia. Risk factors hypoPT include operations, autoimmune disease, central neck dissection, substernal goiter, surgeon inexperience, malabsorptive conditions. Medical surgical minimize perioperative optimizing vitamin D levels, preserving blood supply, autotransplanting ischemic glands. Measurement intraoperative or early postoperative PTH levels thyroidectomy can help guide patient management. In general, <15 pg/mL indicates increased risk acute Effective management mild moderate potential actual be achieved administering either empiric/prophylactic oral calcium D, selective calcium, based on rapid level(s), serial serum as guide. Monitoring rebound hypercalcemia necessary avoid metabolic renal complications. For more severe hypocalcemia, inpatient may necessary. Permanent has long-term consequences both subjective well-being, should prevented whenever possible.