hungry bone syndrome
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Introduction
After parathyroidectomy for cases of severe, prolonged hyperparathyroidism, hypocalcemia with hypophosphatemia may occur as a result of deposition of hydroxyapatite in the calcium-depleted skeleton.
Etiology
- osteitis fibrosa cystica
- hyperthyroidism (case reports)
- risk factors
- larger volume of resected adenoma
- higher preoperative blood urea nitrogen
- higher preoperative serum alkaline phosphatase
- older age
Epidemiology
- uncertain
- incidence 13% in one study
Pathology
- acute reversal of PTH-induced bone resorption
- net increase in bone uptake of Ca+2, H2PO4-, Mg+2
Laboratory
- normal or even elevated serum PTH
- serum calcium: hypocalcemia
- serum phosphorus: hypophosphatemia
- serum magnesium: hypomagnesemia on 3rd postoperative day
- serum potassium: hyperkalemia in dialysis patients
Management
More general terms
Additional terms
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 16. 18. American College of Physicians, Philadelphia 1998, 2012, 2018.
- ↑ UpToDate 11.2 2003 http://www.uptodate.com
- ↑ Mittendorf EA, Merlino JI, McHenry CR. Post-parathyroidectomy hypocalcemia: incidence, risk factors, and management. Am Surg. 2004 Feb;70(2):114-9; PMID: https://www.ncbi.nlm.nih.gov/pubmed/15011912
- ↑ Kaderli RM, Riss P, Dunkler D et al The impact of vitamin D status on hungry bone syndrome after surgery for primary hyperparathyroidism. Eur J Endocrinol. 2018 Jan;178(1):1-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28877925