Endocrine Abstracts

Background: After total thyroidectomy Hypocalcemia is the most frequent complication. Serum calcium levels are reliable only 48–72 hours postoperatively. Now a day’s measurement of iPTH as an early predictor of postoperative hypocalcemia is practiced in many centers.

Objectives: To share our experience for the diagnosis and treatment of post-operative transient and permanent hypoparathyroidism after total thyroidectomy and to assess the ability of iPTH in predicting postoperative hypocalcemia.

Methods: Our total number of patients is 84. iPTH level was measured on 1st postoperative day. Patients were followed up for 1 to 6 months post operatively. Unfortunately, we lose a big number of our patients from follow up.

Results: iPTH on the first postoperative day equal to or less than 15 pg/ml were found to be norm calcemic. iPTH less than 10 pg/ml were disturbed parathyroid hormone metabolism. Hypocalcemia is the most common complication recognized in patients of total thyroidectomy. Around 50% of patients who suffer from transient hypoparathyroidism develop permanent hypoparathyroidism. Measurement of iPTH after surgery is the mainstay of early identification tool in our country though combining postoperative iPTH and serum calcium level can entail more accurate result.

Conclusion: Measurement of iPTH on first postoperative day allow accurate prediction of postoperative parathyroid function in 99% cases. Morbidity due to hypoparathyroidism can be reduced by appropriate dose adjustment of supplemental therapy & lifelong follow up. Till date calcium & vitamin D is the drug of choice.