Parathyroid hormone of ≥1.6 pmol/L at 6 months is associated with recovery in ‘long-term’ post-surgical hypoparathyroidism
Objective: Post-surgical hypoparathyroidism (PoSH) usually settles within few months after thyroid surgery, but several patients require long-term s upplementation with calcium/activated vitamin D. When PoSH persists beyond 6 months , it is considered ‘chronic’ or ‘permanent’, however, late recovery...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-01-01
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| Series: | European Thyroid Journal |
| Subjects: | |
| Online Access: | https://etj.bioscientifica.com/view/journals/etj/11/3/ETJ-21-0130.xml |
| _version_ | 1797955135910969344 |
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| author | Muhammad Fahad Arshad Amardass Dhami Gillian Quarrell Saba Prakash Balasubramanian |
| author_facet | Muhammad Fahad Arshad Amardass Dhami Gillian Quarrell Saba Prakash Balasubramanian |
| author_sort | Muhammad Fahad Arshad |
| collection | DOAJ |
| description | Objective: Post-surgical hypoparathyroidism (PoSH) usually settles within few months after thyroid surgery, but several patients require long-term s upplementation with calcium/activated vitamin D. When PoSH persists beyond 6 months , it is considered ‘chronic’ or ‘permanent’, however, late recovery has been repor ted. The aim of this study was to determine the frequency of late recovery and explore fac tors predicting late recovery of parathyroid function.
Methods: Adult patients undergoing total/completion thyroidectomy between 2009 and 2018 were included in this retrospective cohort observational s tudy. The records of patients with evidence of PoSH were reviewed to identify those with persisting PoSH at 6 months. Demographic, biochemical, surgical, pathological, and clinical follow-up data were collected and analysed.
Results: Out of 911 patients undergoing thyroidectomy, 270 were identifi ed with PoSH. Of these, 192 were started on supplements and 138 (71.9%) recov ered within 6 months. Of the remaining 54 patients, 35 had ongoing PoSH with median ( range) follow-up of 3.4 (0.5–11.1) years. Nineteen patients were weaned off suppleme nts and achieved remission at median (range) follow-up of 1.3 (0.6–4.8) years. A ll of those who recovered had a PTH of ≥1.6 pmol/L at 6 months. There was no difference in age, gender, diagnosis, type, and extent of surgery between those who did an d did not show late recovery.
Conclusions: Recovery from PoSH is common beyond 6 months, raising the ques tion whether a 6-month threshold to define ‘long-term’ PoSH is approp riate. The chances of recovery are high (~50%) in patients with PTH level ≥1.6 pmol/L at 6 months, where attempts at weaning may be focussed. |
| first_indexed | 2024-04-10T23:28:26Z |
| format | Article |
| id | doaj.art-579408581d0f4a4e818ea07ed57fe030 |
| institution | Directory Open Access Journal |
| issn | 2235-0802 |
| language | English |
| last_indexed | 2024-04-10T23:28:26Z |
| publishDate | 2023-01-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | European Thyroid Journal |
| spelling | doaj.art-579408581d0f4a4e818ea07ed57fe0302023-01-12T10:55:00ZengBioscientificaEuropean Thyroid Journal2235-08022023-01-0111319https://doi.org/10.1530/ETJ-21-0130Parathyroid hormone of ≥1.6 pmol/L at 6 months is associated with recovery in ‘long-term’ post-surgical hypoparathyroidismMuhammad Fahad Arshad0Amardass Dhami1Gillian Quarrell2Saba Prakash Balasubramanian3Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; University of Sheffield, Sheffield, UKSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; University of Sheffield, Sheffield, UKObjective: Post-surgical hypoparathyroidism (PoSH) usually settles within few months after thyroid surgery, but several patients require long-term s upplementation with calcium/activated vitamin D. When PoSH persists beyond 6 months , it is considered ‘chronic’ or ‘permanent’, however, late recovery has been repor ted. The aim of this study was to determine the frequency of late recovery and explore fac tors predicting late recovery of parathyroid function. Methods: Adult patients undergoing total/completion thyroidectomy between 2009 and 2018 were included in this retrospective cohort observational s tudy. The records of patients with evidence of PoSH were reviewed to identify those with persisting PoSH at 6 months. Demographic, biochemical, surgical, pathological, and clinical follow-up data were collected and analysed. Results: Out of 911 patients undergoing thyroidectomy, 270 were identifi ed with PoSH. Of these, 192 were started on supplements and 138 (71.9%) recov ered within 6 months. Of the remaining 54 patients, 35 had ongoing PoSH with median ( range) follow-up of 3.4 (0.5–11.1) years. Nineteen patients were weaned off suppleme nts and achieved remission at median (range) follow-up of 1.3 (0.6–4.8) years. A ll of those who recovered had a PTH of ≥1.6 pmol/L at 6 months. There was no difference in age, gender, diagnosis, type, and extent of surgery between those who did an d did not show late recovery. Conclusions: Recovery from PoSH is common beyond 6 months, raising the ques tion whether a 6-month threshold to define ‘long-term’ PoSH is approp riate. The chances of recovery are high (~50%) in patients with PTH level ≥1.6 pmol/L at 6 months, where attempts at weaning may be focussed.https://etj.bioscientifica.com/view/journals/etj/11/3/ETJ-21-0130.xmlpost-surgical hypoparathyroidismrecoveryparathyroid hormonelong-term |
| spellingShingle | Muhammad Fahad Arshad Amardass Dhami Gillian Quarrell Saba Prakash Balasubramanian Parathyroid hormone of ≥1.6 pmol/L at 6 months is associated with recovery in ‘long-term’ post-surgical hypoparathyroidism European Thyroid Journal post-surgical hypoparathyroidism recovery parathyroid hormone long-term |
| title | Parathyroid hormone of ≥1.6 pmol/L at 6 months is associated with recovery in ‘long-term’ post-surgical hypoparathyroidism |
| title_full | Parathyroid hormone of ≥1.6 pmol/L at 6 months is associated with recovery in ‘long-term’ post-surgical hypoparathyroidism |
| title_fullStr | Parathyroid hormone of ≥1.6 pmol/L at 6 months is associated with recovery in ‘long-term’ post-surgical hypoparathyroidism |
| title_full_unstemmed | Parathyroid hormone of ≥1.6 pmol/L at 6 months is associated with recovery in ‘long-term’ post-surgical hypoparathyroidism |
| title_short | Parathyroid hormone of ≥1.6 pmol/L at 6 months is associated with recovery in ‘long-term’ post-surgical hypoparathyroidism |
| title_sort | parathyroid hormone of ≥1 6 pmol l at 6 months is associated with recovery in long term post surgical hypoparathyroidism |
| topic | post-surgical hypoparathyroidism recovery parathyroid hormone long-term |
| url | https://etj.bioscientifica.com/view/journals/etj/11/3/ETJ-21-0130.xml |
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