Parathyroid Hormone as a Predictor of Hypocalcaemia after Total Thyroidectomy

Parathyroid hormone as a predictor of hypocalcaemia after total thyroidectomy Dr Rakesh R, Dr Bathala Udayee Teja, Dr MN Surendra, Dr Ramesh Reddy. Background Thyroidectomy has been established as the preferred operation for various thyroid disorders. Post-operative hypocalcaemia is one of the major concerns following total thyroidectomy. Our study aims to determine whether measurement of parathyroid hormone level in immediate postoperative period in total thyroidectomy patients could predict hypocalcaemia and to standardize the test levels to predict the hypocalcaemia postoperatively Study design A single institution, prospective study over a period of one year. Results Hypocalcaemia was noted in 36 % of patients at 24 hours post total thyroidectomy, out of which 12 % of patients were symptomatic which required medical management. Post-operative hypocalcaemia developed 2.03.13 day after surgery. High incidence of hypocalcaemia in malignant disease who underwent total thyroidectomy with or without neck dissection, followed by surgery for graves disease. Postoperative serum calcium level was statistically lower than the preoperative serum calcium level irrespective of whether the patient is symptomatic or not, which was in correlation to the serum PTH levels post operatively, signifying that PTH levels drop is an early predictor of hypocalcaemia patients undergoing total thyroidectomy Conclusion Serum PTH hormone levels should be checked for all patients undergoing total thyroidectomy at 2 hours post operatively, which is a reliable early predictor for patients going in for hypocalcaemia even before serum calcium levels drop which takes at least 24-48 hours, and hence predicting patients in risk of developing hypocalcaemia and treat them prophylactically.