Endocrine Abstracts

Introduction: Primary hyperparathyroidism (PHP) is a common endocrine disease, and its most effective treatment is surgery. Hungry bone syndrome (HBS) is one of the complications that can occur after parathyroidectomy, and that can cause severe and prolonged hypocalcemia. The aim of this study was to determine the risk factors for HBS in patients who underwent parathyroidectomy for PHP.

Patients and Methods: This is a retrospective descriptive and analytic study of 48 patients with primary hyperparathyroidism followed-up in the Endocrinology-Diabetology and Nutrition Department of the University Hospital Center of Mohammed-VI-Oujda in Morocco, from which 36 patients underwent parathyroidectomy, and were included in this study.

Results: Out of the patients included in the study, 3 cases (8.3%) had HBS, and 33 cases (91.7%) didn’t develop HBS. Compared to patients who didn’t have this complication, these patients had a lower age (43.33±16 vs 54.6±10.7 years). A feminin predominance was observed in both groups. The preoperative biological analysis demonstrated: higher serum levels of calcium (135.4±8.2 vs 120.1±27.4 mg/l), of PTH 1-84 (1423±1209.6 vs 413.56±379.5 pg/ml), of ALP (436.2±281.6 vs 178.61±103.9UI/l) and lower levels of phosphorus (16.7±1.5 vs 21.57±5.9 mg/l) and of vitamin D (6.3±1.7 vs 11.8±6.3 ng/ml) in the HBS group. A significant association was found between higher preoperative levels of ALP (P=0.04) and PTH 1-84 (P<0.001) and the occurrence of HBS. Cervical ultrasound showed no difference in number of adenomas between the 2 groups (1 localisation). Bone densitometry indicated osteoporosis in the 3 cases of HBS.

Conclusion: Based on these readily obtainable parameters and the results of our study, higher preoperative ALP and PTH 1-84 levels, were significantly associated with a greater risk of development of the hungry bone syndrome following parathyroid surgery.