Chronic hypoparathyroidism after thyroid surgery: Benefits of specialized and personalized care in a tertiary public hospital

Abstract

Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: June 24, 2019. Accepted: October 01, 2019. The study was carried out at Serviço de Cirurgia de Cabeça e Pescoço, Faculdade de Medicina, Hospital das Clínicas, Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brasil. Article presented at the XXVII Congresso Brasileiro de Cirurgia de Cabeça e Pescoço, in August 2019 Abstract Introduction: As the number of thyroid operations increases, the incidence of complications also increases, including transitory and definite hypoparathyroidism. Since each patient presents different and unpredictable symptoms, affecting several organs and systems, they need personalized care. Even when patients presented with low calcium blood levels, the previous results were considered acceptable, usually using oral prescriptions of calcium carbonate and calcitriol. We created in March 2017 a specialized outpatient treatment facility for those patients focused on generating experience and knowledge about hypoparathyroidism. Objective: To analyze the challenges and the impact of specialized care in diagnosis, treatment and in follow-up of patients with postoperative hypoparathyroidism, with potential to improve teaching and further research possibilities in the subject. Methods: 61 patients were studied: 55 women, age 18-55. A retrospective study was performed, considering specialized guidelines. We also analyzed blood levels of calcium, parathyroid hormone, vitamin D, and other minerals; kidney function; bone structure. Results: Some patients needed drug dose adjustments up to 66%. We were able to identify kidney structural and functional changes. We could share those experiences in a multidisciplinary way, contributing significantly to provide more experience to the medical residents. Conclusion: Specialized outpatient treatment is responsible for providing more efficient and safe treatment to the patients, and it is also important to enable further medical research.