ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Persistent post-operative hypoparathyroidism: Cardiac and psychiatric co-morbidities need to be correlated with vitamin D and calcium replacement

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Introduction: Postoperative hypoparathyroidism is one of common complications of surgery for thyroid and or parathyroid glands due to removal, destruction or vascular compromise of parathyroid tissue. In addition to classical neuromuscular symptoms of hypocalcemia, hypoparathyroidism may also associate complex cardiovascular or psychiatric symptoms, potentially correlated with calcium profile.

Case report: A 65-year-old male with a history of total thyroidectomy for multinodular goiter started two weeks after to accuse muscle cramps, fatigue weakness in extremities, headache, inability to focus, anxiety despite oral supplementation of calcium and vitamin D which were re-adjusted. Four months after surgery, he was diagnosed with depression and in another two months he had a stroke. Eight months after surgery, he was re- admitted for an endocrine check-up. Despite therapy, inadequate levels of calcium were found once again and increased supplementation was needed. This was enough to improve the mood disorder and reduce the associated specific medication. However, specific therapy from cardiology and psychiatry was continued for a long-term. A good collaboration within a multidisciplinary team is needed for follow-up.

Conclusion: Co-morbidities displayed after permanent postoperative hypoparathyroidism confirmation may be potentially connected with low calcium levels thus adequate supplementation and follow-up are constantly needed to have a better outcome.

Abbreviations: HypoPT = Hypoparathyroidism, PTH = parathormone, FT4 = Free Thyroxine, TSH = Thyroid Stimulating Hormone

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