Endocrine Abstracts

We present a case of a 43 year-old male with permanent post-operative hypoparathyroidism following total thyroidectomy for toxic nodular goitre. His medical history includes Mccune-Albright syndrome and mild right optic atrophy. He had prolonged hospital stay post-surgery due to persistent severe hypocalcaemia with mild hypomagnesemia. Post-surgery, hypocalcaemia was treated with intermittent calcium infusion, oral calcium and D3 supplements and vitamin D analogues of alfacalcidol 4 microgram daily which was switched to calcitriol 2 mg daily due to lack in calcium improvement. He was also commenced on regular oral magnesium replacements. Despite maximal oral and intravenous treatment, normocalcaemia was not achieved hence recombinant PTH of Teriparatide was commenced at 40 mg daily subcutaneously. He was discharged following normocalcaemia and was regularly followed up for calcium monitoring. Hypoparathyroidism and hypocalcaemia is a common postoperative complication after total thyroidectomy. Standard treatment with supplementation of calcium and vitamin D analogues, usually treat this condition. Uncommonly, in some cases including our patient, hypoparathyroidism is refractory to standard treatment and recombinant PTH is required to achieve normocalcaemia.