Publicaciones científicas

Late Recovery of Parathyroid Function After Total Thyroidectomy: A Case-Control Study

01-oct-2021 | Revista: Hormone and Metabolic Research

Juan José Díez  1   2 , Emma Anda  3 , Julia Sastre  4 , Begoña Pérez Corral  5 , Cristina Álvarez-Escolá  6 , Laura Manjón  7 , Miguel Paja  8 , Marcel Sambo  9 , Piedad Santiago Fernández  10   11 , Concepción Blanco Carrera  12 , Juan Carlos Galofré  13 , Elena Navarro  14 , Carles Zafón  15 , Eva Sanz  15 , Amelia Oleaga  8 , Orosia Bandrés  16 , Sergio Donnay  17 , Ana Megía  18 , María Picallo  9 , Cecilia Sánchez Ragnarsson  7 , Gloria Baena-Nieto  19 , José Carlos Fernández-García  20   21 , Beatriz Lecumberri  6 , Manel Sahún de la Vega  22 , Ana R Romero-Lluch  14 , Pedro Iglesias  1   2


The clinical characteristics of patients with postoperative hypoparathyroidism who recover parathyroid function more than 12 months after surgery have not been studied.

We aimed to evaluate whether the intensity of replacement therapy with calcium and calcitriol is related to the late recovery of parathyroid function. We compared the demographic, surgical, pathological, and analytical features of two groups of patients: cases, i. e., late recovery patients (those who recover parathyroid function>1 year after thyroidectomy, n=40), and controls, i. e., patients with permanent hypoparathyroidism (n=260).

Replacement therapy with calcium and calcitriol was evaluated at discharge of surgery, 3-6 months, 12 months, and last visit. No significant differences were found in clinical, surgical, pathological, or analytical characteristics between cases and controls.

The proportion of cases who required treatment with calcium plus calcitriol at 12 months was significantly lower than that found in controls (p<0.001). Furthermore, daily calcium and calcitriol doses in controls were significantly higher than those in cases at 3-6 months (p=0.014 and p=0.004, respectively) and at 12 months (p<0.001 and p=0.043, respectively). In several models of logistic regression analysis therapy with calcium and calcitriol at 12 months was negatively related to late recovery of parathyroid function.

Although delayed recuperation of parathyroid function after total thyroidectomy is uncommon (13%), follow-up beyond 12 months is necessary in patients with postoperative hypoparathyroidism, especially in those whose needs of treatment with Ca and calcitriol are reducing over time.

CITA DEL ARTÍCULO  Horm Metab Res. 2021 Oct;53(10):654-661. doi: 10.1055/a-1608-1373. Epub 2021 Sep 13