Correction of Hypocalcemia in Various Thyroid Diseases after Thyroidectomy

Abstract

Without regard to considerable successes in the surgical treatment of thyroid diseases, questions of prevention and correction of postoperative hypoparathyroidism with the development of clear recommendations for the selection of optimal schemes of correction for postoperative hypocalcemia remain topical and still unsolved. The purpose of this study: to work out the differentiated scheme of treatment for postoperative hypoparathyroidism and to define optimal therapy of hypocalcemia after thyroidectomy in different thyroid diseases. Materials and methods. In a prospective study of 77 patients after thyroidectomy for various thyroid disease, a surveillance was conducted within 6 months, with a regular assessment of phosphorus-calcium metabolism performance. According to the treatment regimen, patients were divided into three groups depending on the baseline values of 25(OH)D before surgery and parathyroid hormone levels after surgery. Results. The optimal scheme for the correction of postoperative hypocalcemia is a combination of calcium preparation and analogs of the active metabolite of vitamin D, which provides a quick positive dynamics of the main indicators of phosphorous-calcium metabolism, while achieving sustainable effect. All patients with thyroid disease are recommended to determine 25(OH)D during preoperative preparation in order to use this index as a predictive factor of postoperative hypocalcemia. Conclusions. Upon detection of hypocalcemia after thyroidectomy it is recommended to start combined treatment with calcium preparations and analogs of the active metabolite of vitamin D, regardless of nosology of thyroid pathology, extent of operation, however, individually controlled dosage selection of key indicators of phosphorous-calcium metabolism should be done.