scholarly journals Evaluation of Serum Calcium Level Measurement in Total Thyroidectomy Patients - A Prospective Study in Tertiary Hospitals

2013 ◽  
Vol 4 (1) ◽  
pp. 4-9 ◽  
Author(s):  
MS Islam ◽  
D Paul ◽  
T Sultana ◽  
MQ Rahman ◽  
Z Rehena ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Critical Time ◽  
Clinical Pathology ◽  
Level Measurement ◽  
Tertiary Hospitals ◽  
Symptomatic Hypocalcemia ◽  
A Prospective Study

Postoperative hypocalcemia is the most frequent and common complication after total thyroidectomy. It is necessary to diagnose hypocalcemia immediately after total thyroidectomy for minimizing complications. The objective of this study was to measure and to evaluate the serum calcium level in total thyroidectomy patients. This prospective observational study was carried out in the Department of Clinical Pathology in collaboration with Department of Surgery & Department of Otolaryngology of BSMMU and Department of Otolaryngology of DMCH, Dhaka, during the period of September 2010 to August 2011. Total 65 patients were enrolled those came for total thyroidectomy irrespective of age and sex. Hypocalcemia was found in 25 cases and normocalcemia was found in 40 cases. Male were 16.0% and female were 84.0%. Females were predominant. The incidence of hypocalcemia was 38.5%. Asymptomatic hypocalcemia was found in 22 and symptomatic hypocalcemia was found in 3 cases. Hypocalcemia was developed mostly in malignant thyroid diseases. The mean difference of intraoperative (20 minutes after total thyroidectomy), after 24 hours and after 48 hours calcium levels were statistically significant (p<0.05) between patient with hypocalcemia and patient with normocalcemia in unpaired t-test. Serum calcium level significantly decreased after total thyroidectomy and most critical time is first 24 hours of post-thyroidectomy period. If clinical sign symptoms of hypocalcemia are not developed in this period, patient is safe and can be discharged from hospital.DOI: http://dx.doi.org/10.3329/bjmb.v4i1.13775 Bangladesh J Med Biochem 2011; 4(1): 4-9

Calcium-Alkali Syndrome Associated with Hypoparathyroidism Following Total Thyroidectomy

2020 ◽  
Vol 51 (2) ◽  
pp. 160-167
Author(s):  
Sayaka Kuroya ◽  
Masahiko Yazawa ◽  
Yugo Shibagaki ◽  
Naoto Tominaga
Keyword(s):  
Vitamin D ◽  
Renal Impairment ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Metabolic Alkalosis ◽  
Calcium Supplementation ◽  
Parathyroid Autotransplantation ◽  
High Calcium

Background: Patients with permanent postsurgical hypoparathyroidism, a complication of total thyroidectomy, often require high calcium supplementation with vitamin D to maintain serum calcium levels. The epidemiology of calcium-alkali syndrome (CAS) in patients with hypoparathyroidism after total thyroidectomy remains unclear. This study aimed to investigate the incidence of hypercalcemia, renal impairment, metabolic alkalosis, and CAS in patients treated for presumed hypoparathyroidism after total thyroidectomy. Methods: Twenty-seven patients with neck cancers who underwent total thyroidectomy without parathyroid autotransplantation between January 2010 and October 2013 at our hospital were consecutively included. All patients received calcium lactate and alfacalcidol for postsurgical hypocalcemia. We defined hypercalcemia as a corrected serum calcium level (cCa) ≥10.5 mg/dL, metabolic alkalosis as a difference in serum sodium and serum chloride ([sNa-sCl]) ≥39 mEq/L, and renal impairment as a ≥50% increase in serum creatine and/or ≥35% decrease in estimated glomerular filtration rate (eGFR) compared to baseline. Results: cCa peaked (11.1 ± 1.5 mg/dL) at a median of 326 days (interquartile range 78–869) after surgery. At peak cCa, [sNa-sCl] was significantly higher (p < 0.01), and eGFR was significantly lower (p < 0.01) than that at baseline. Fifteen patients (55.6%) had hypercalcemia, 19 (70.3%) had alkalosis, 12 (44.4%) had renal impairment, and 9 (33.3%) had CAS. Patients with CAS (mean age 67.1 ± 10.8 years) were older than those without CAS (56.7 ± 13.6 years, p = 0.06). The mean dose of alfacalcidol in the CAS group (3.1 ± 1.2 μg/day) was significantly larger than that in the non-CAS group (2.1 ± 1.0 μg/day, p = 0.03). Conclusions: This retrospective study reveals the high incidence of CAS in patients with hypoparathyroidism after total thyroidectomy. Furthermore, these findings suggest that the serum calcium level, acid-base balance, and renal function should be closely monitored in patients with postsurgical hypoparathyroidism who receive large doses of active vitamin D.

The serum calcium level and its significance in hyperthyroidism: a prospective study

1974 ◽  
Vol 268 (1) ◽  
pp. 31-36 ◽  
Author(s):  
DONALD L. GORDON ◽  
SUNANT SUVANICH ◽  
VIVIAN ERVITI ◽  
MAURICE A. SCHWARTZ ◽  
CHARLES J. MARTINEZ
Keyword(s):  
Prospective Study ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
A Prospective Study

scholarly journals Serum Calcium Level in Mild and Severe Preeclampsia- A study in Combined Military Hospital, Dhaka

2018 ◽  
Vol 9 (1) ◽  
pp. 255-257
Author(s):  
Marlina Roy ◽  
Asma Rahman ◽  
Hafsa Begum ◽  
Rokeya Khan ◽  
Nasrin Hasan ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Calcium Supplementation ◽  
Clinical Pathology ◽  
Severe Preeclampsia ◽  
Military Hospital ◽  
Fetal Mortality ◽  
Cross Sectional ◽  
Mild Preeclampsia

Background : Hypertensive disorders are the most common medical complications during pregnancy and are associated with high maternal and fetal mortality and morbidity.Half of the pregnant women with hypertension have preeclampsia. Association of low serum calcium level with preeclampsia(PE) is known decades together.Objectives : To assess serum calcium level in mild and severe preeclampsia(PE).Materials and Method : This was a comparative cross sectional study conducted in the department of Obstetric and Gynaecology, Combined Military Hospital (CMH),Dhaka, Bangladesh. The data were collected from 50 mild preeclampsia and 50 severe preeclampsia patients admitted in Obstetric and Gynaecology ward of CMH who fulfill the inclusion criteria. Study period was July 2015 to December 2015. Serum calcium was measured in Auto analyzer machine in the clinical pathology of Armed forced Institute of pathology (AFIP). Data were analyzed by statistical software, SPSS version 20.Results : Serum calcium level was found in severe PE was 8.12mg/dl and in mild PE was 8.85mg/dl. Study also reveals that routine calcium supplementation was consumed less in severe PE than mild PE patients.Conclusion : Serum calcium is markedly reduce in severe preeclampsia than in mild preeclampsia. Therefore routine examination of serum calcium level may be useful as diagnostic marker in high risk pregnancy.Northern International Medical College Journal Vol.9(1) July 2017: 255-257

scholarly journals Bilateral hypocalcemic cataract after total thyroidectomy in a young woman: Case report

2019 ◽  
Author(s):  
kumale tolesa daba ◽  
Dagmawit Kifle W/ Michael ◽  
Gersam Abera Mulugeta
Keyword(s):  
Case Report ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Soft Tissues ◽  
Posterior Cortex ◽  
Thyroid Gland Surgery ◽  
Systemic Examination ◽  
Toxic Goiter

Abstract Background: Hypocalcemia is a derangement in serum calcium level due to a vast spectrum of disorders, but the most common cause is surgery, usually thyroid gland surgery. Symptoms of hypocalcemia can be due to increased neuromuscular excitation resulting in tetany, paresthesia or seizure. It can also be because of deposition of calcium in soft tissues producing reduced vision /cataract or calcification of basal ganglia. Cataract is the most common ocular symptom of hypocalcemia. Case report: A twenty-six years old Ethiopian female patient presented with painless reduction of vision of both eyes. Five years prior to the reduction of vision she was diagnosed to have hypocalcemia. The serum calcium level was very low (3mg/dl) due to damage to the parathyroid gland during total thyroidectomy for toxic goiter. She has been on supplemental calcium gluconate twice daily. She had typical bilateral symmetrical posterior sub capsular cataract with punctate iridescent opacities in the anterior and posterior cortex of the lens. Systemic examination revealed horizontal surgical scar on the anterior neck and positive Chvostek sign.

scholarly journals Bilateral hypocalcemic cataract after total thyroidectomy in a young woman: Case report

2019 ◽  
Author(s):  
kumale tolesa daba ◽  
Dagmawit Kifle W/ Michael ◽  
Gersam Abera Mulugeta
Keyword(s):  
Case Report ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Soft Tissues ◽  
Posterior Cortex ◽  
Thyroid Gland Surgery ◽  
Systemic Examination ◽  
Toxic Goiter

Abstract Background: Hypocalcemia is a derangement in serum calcium level due to a vast spectrum of disorders, but the most common cause is surgery, usually thyroid gland surgery. Symptoms of hypocalcemia can be due to increased neuromuscular excitation resulting in tetany, paresthesia or seizure. It can also be because of deposition of calcium in soft tissues producing reduced vision /cataract or calcification of basal ganglia. Cataract is the most common ocular symptom of hypocalcemia. Case report: A twenty-six years old Ethiopian female patient presented with painless reduction of vision of both eyes. Five years prior to the reduction of vision she was diagnosed to have hypocalcemia. The serum calcium level was very low (3mg/dl) due to damage to the parathyroid gland during total thyroidectomy for toxic goiter. She has been on supplemental calcium gluconate twice daily. She had typical bilateral symmetrical posterior sub capsular cataract with punctate iridescent opacities in the anterior and posterior cortex of the lens. Systemic examination revealed horizontal surgical scar on the anterior neck and positive Chvostek sign. Key words: Hypocalcemia, bilateral cataract, total thyroidectomy, hypoparathyroidism, tetany, serum calcium and Ethiopia.

scholarly journals Correlation of pre-operative vitamin D3 levels with post-operative hypocalcemia in patients undergoing total thyroidectomy

2019 ◽  
Vol 7 (1) ◽  
pp. 128
Author(s):  
Mallikarjuna M. N. ◽  
Arun Kumar ◽  
Ramya M. V. ◽  
Santhosh C. S.
Keyword(s):  
Vitamin D ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Vitamin D3 ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Serum Vitamin ◽  
Hypovitaminosis D ◽  
Preoperative Serum ◽  
Vitamin D Levels

Background: Total thyroidectomy (TT) is a commonly performed procedure for various  thyroid disorders, with parathyroid insufficiency manifesting as hypocalcaemia being a well-known complication. Albeit, vitamin D is well implicated in calcium homeostasis, the association between hypovitaminosis D and postoperative hypocalcaemia is yet to be concluded. The aim of our study is to evaluate the correlation of preoperative serum vitamin D3 levels  with occurrence of post-operative hypocalcemia in patients undergoing TT.Methods: A prospective  study  was conducted on 50 patients  undergoing TT for benign thyroid diseases from November 2016 to May 2018. Pre-operative vitamin D3 levels were estimated. Serum calcium levels was measured pre‑ and post‑operatively at 24hours, 1st week and 4th week. Serum calcium level ≤8.5 mg/dl was considered as biochemical hypocalcemia. A data of demographic, clinical, biochemical and intraoperative findings were documented and analysed.Results: Statically 14 (28%) patients developed symptomatic hypocalcemia. Out of these, 11 (78.5%) patients had preoperative vitamin D levels of <30 ng/dl (p=0.034). 24 hours postoperative serum calcium level was significantly  lesser in patients with  lower preoperative vitamin D levels (p=0.015), suggesting that postoperative  hypocalcemia (24 hr) is statistically related to pre-operative vitamin D3 levels.Conclusions: It could be concluded from our study that preoperative serum vitamin D3 levels can predict post-operative occurrence of symptomatic and/or biochemical hypocalcemia. Thus, it could be hypothesized that supplementing vitamin D preoperatively could curb the incidence of hypocalcaemia following TT. However, further relevant trials are needed to attest to this. 

scholarly journals Bilateral hypocalcemic cataract after total thyroidectomy in a young woman: case report

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kumale Tolesa Daba ◽  
Dagmawit Kifle Weldemichael ◽  
Gersam Abera Mulugeta
Keyword(s):  
Case Report ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Soft Tissues ◽  
Posterior Cortex ◽  
Thyroid Gland Surgery ◽  
Systemic Examination ◽  
Toxic Goiter

Abstract Background Hypocalcemia is a derangement in serum calcium level due to a vast spectrum of disorders, but the most common cause is surgery, usually thyroid gland surgery. Symptoms of hypocalcemia can be due to increased neuromuscular excitation resulting in tetany, paresthesia or seizure. It can also be because of deposition of calcium in soft tissues producing reduced vision /cataract or calcification of basal ganglia. Cataract is the most common ocular symptom of hypocalcemia. Case report A twenty-six years old Ethiopian female patient presented with painless reduction of vision of both eyes. Five years prior to the reduction of vision she was diagnosed to have hypocalcemia. The serum calcium level was very low (3 mg/dl) due to damage to the parathyroid gland during total thyroidectomy for toxic goiter. She has been on supplemental calcium gluconate twice daily. She had typical bilateral symmetrical posterior sub capsular cataract with punctate iridescent opacities in the anterior and posterior cortex of the lens. Systemic examination revealed horizontal surgical scar on the anterior neck and positive Chvostek sign.

scholarly journals Bilateral hypocalcemic cataract after total thyroidectomy in an Ethiopian young woman: Case report

2019 ◽  
Author(s):  
kumale tolesa daba ◽  
Dagmawit Kifle W/ Michael ◽  
Gersam Abera Mulugeta
Keyword(s):  
Case Report ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Soft Tissues ◽  
Young Patients ◽  
Posterior Cortex ◽  
Systemic Examination ◽  
Toxic Goiter

Abstract Introduction: Hypocalcemia is a derangement in serum calcium level due to a vast spectrum of disorders, but the most common cause is surgery, usually thyroid gland surgery. Symptoms of Hypocalcemia can be due to increased neuromuscular excitation resulting in tetany, paresthesia or seizure. It can also be because of deposition of calcium in soft tissues producing reduced vision /cataract or calcification of basal ganglia. Cataract is the most common ocular symptom of hypocalcemia. Case report: A twenty six years old Ethiopian female patient presented with painless reduction of vision of both eyes 5 years after she was diagnosed to have hypocalcemia with very low serum calcium level (3mg/dl) due to damage to the parathyroid gland during total thyroidectomy for toxic goiter and has been on supplemental calcium gluconate twice daily. She had typical bilateral symmetrical posterior sub capsular cataract with punctate iridescent opacities in the anterior and posterior cortex of the lens. Systemic examination revealed horizontal surgical scar on the anterior neck and Positive Chvostek sign. Conclusion:The work up of bilateral symmetrical cataract in young patients should include serum electrolyte levels, particularly calcium, in those who had history of thyroid surgery. Key words: Hypocalcemia, bilateral cataract, total thyroidectomy, hypoparathyroidism, tetany, serum calcium and Ethiopia.

scholarly journals Clinicopathological Risk Factors and Biochemical Predictors of Safe Discharge after Total Thyroidectomy and Central Compartment Node Dissection for Thyroid Cancer: A Prospective Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Yu-mi Lee ◽  
Ja Young Cho ◽  
Tae-Yon Sung ◽  
Tae Yong Kim ◽  
Ki-Wook Chung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Serum Calcium Level ◽  
Female Gender ◽  
Central Compartment ◽  
Symptom Development ◽  
Node Dissection ◽  
Intact Pth ◽  
A Prospective Study

To determine the clinicopathological risk factors and reliable biochemical predictors of the development of hypocalcemic symptoms after total thyroidectomy on the basis of serum calcium and intact parathyroid hormone (PTH) levels measured 1 hour after surgery, a prospective study was performed on 817 patients who underwent a total thyroidectomy with central compartment node dissection (CCND) due to well-differentiated thyroid cancer. We evaluated the correlations between hypocalcemic symptom development and clinicopathological factors. And the predictability for hypocalcemic symptom development of intact PTH cut-offs (<10 pg/mL and <20 pg/mL, resp.) according to serum calcium level subgroup was analyzed. Female gender (P<0.001) was the only independent risk factor for hypocalcemic symptom development in multivariate regression analysis. The negative predictive value (NPV) of intact PTH, signifying nondevelopment of hypocalcemic symptoms, was higher than the positive predictive value (PPV) which signified development of hypocalcemic symptoms. In addition, when we applied the different adoption of the intact PTH cut-off according to serum calcium level, we could obtain more increased NPVs. A female gender and the application of more specific cut-offs for intact PTH according to the serum calcium levels measured 1 hour after surgery may help the patients to be more safely discharged.

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