Endocrine Abstracts

Post parthyroïdectomy hypocalcemia is a frequent situation, generally due to a definitive or transient hypoparathyroïdism.

The ‘Hungry bone syndrome’, is a rare severe hypocalcemia etiology, assigned to an excessive osseous avidity, occurring in intense bone remodeling situations like fibrous osteitis or renal osteodystrophy.

We report a case of a 41 years old woman, presenting a chronic renal failure, at hemodialysis stage, complicated by a tertiary hyperparathyroidism, which was treated by a total parathyroïdectomy.

At immediate post operative follow-up the patient presented a severe hypocalcemia getting to 1.27 nmol/l, associated to a hypophosphoremia and elevation of the alkaline phosphatasis by 4000 UI/L, by what we diagnosed a ‘Hungry bone syndrome’.

To control calcemia, we had to administrate a consequent dose of calcium and vitamin D, reaching 8000 mg/day of calcium gluconate, and 4 μg/day of calcitriol.

In conclusion, the ‘Hungry bone syndrome’, is a rare severe hypocalcemia situation, which is difficult to control; requiring an adequate managing. The prevention of this disease could relie on a good post operative vitamin D deficit supplementation.