{"title":"甲状腺切除术后低镁血症:前瞻性观察-初步研究","authors":"A. Abdulkareem","doi":"10.4103/sjl.sjl_10_20","DOIUrl":null,"url":null,"abstract":"Background: Magnesium plays a role in the active transport of calcium (Ca+2) and potassium ions across cell membranes. Most of Mg+2 is intracellular or in the bone <1% is in the blood serum. Post thyroidectomy, hypoparathyroidism leads to acute hypocalcemia that leads to hypomagnesemia. The relation of Ca+2 and magnesium (Mg+2) metabolism is complex and mainly related to the interaction of these cations with parathyroid hormone (PTH) post thyroidectomy. Magnesium is an essential regulator of Ca+2 flux and intracellular action of Ca+2. Hypomagnesemia impairs hypocalcaemia-induced PTH release, which is corrected rapidly after magnesium replacement. Attempting to correct only hypocalcemia may prolong symptoms. It is important to monitor both Ca+2 and Mg+2 levels following thyroidectomy to facilitate prompt resolution of symptoms. The aim: is to highlight the prevalence of hypomagnesemia following thyroidectomy and its association with hypocalcemia which mandate early recognition and treatment to prevent prolongation of hypocalcemia and permanent hypoparathyroidism. Methods: Institutional review board was obtained (E20-4615) and posted in ClinicalTrials.gov NCT04351451. Informed consent taken from all patients. This is a prospective open Label observational pilot study in patients who underwent thyroidectomy. The study period was from January 2019 to January 2020. A total of 74 patients with normal renal function. Serum Ca+2, magnesium, phosphate level, and Vitamin D level are all checked preoperatively and in the first postoperative day. Results: Post thyroidectomy 56.8% of patients had hypomagnesemia. 59.5.1% had hypocalcemia and 41.9% of had combined low level of Ca+2 and Mg+2 (P = 0.004). Conclusions: Causes of hypocalcemia and hypomagnesemia following thyroidectomy is of multi factorial related mainly to Ca+2, Mg+2 interaction in relation to PTH level.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"58 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hypomagnesemia following thyroidectomy: Prospective observational - Pilot study\",\"authors\":\"A. Abdulkareem\",\"doi\":\"10.4103/sjl.sjl_10_20\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Magnesium plays a role in the active transport of calcium (Ca+2) and potassium ions across cell membranes. Most of Mg+2 is intracellular or in the bone <1% is in the blood serum. Post thyroidectomy, hypoparathyroidism leads to acute hypocalcemia that leads to hypomagnesemia. The relation of Ca+2 and magnesium (Mg+2) metabolism is complex and mainly related to the interaction of these cations with parathyroid hormone (PTH) post thyroidectomy. Magnesium is an essential regulator of Ca+2 flux and intracellular action of Ca+2. Hypomagnesemia impairs hypocalcaemia-induced PTH release, which is corrected rapidly after magnesium replacement. Attempting to correct only hypocalcemia may prolong symptoms. It is important to monitor both Ca+2 and Mg+2 levels following thyroidectomy to facilitate prompt resolution of symptoms. The aim: is to highlight the prevalence of hypomagnesemia following thyroidectomy and its association with hypocalcemia which mandate early recognition and treatment to prevent prolongation of hypocalcemia and permanent hypoparathyroidism. Methods: Institutional review board was obtained (E20-4615) and posted in ClinicalTrials.gov NCT04351451. Informed consent taken from all patients. This is a prospective open Label observational pilot study in patients who underwent thyroidectomy. The study period was from January 2019 to January 2020. A total of 74 patients with normal renal function. Serum Ca+2, magnesium, phosphate level, and Vitamin D level are all checked preoperatively and in the first postoperative day. Results: Post thyroidectomy 56.8% of patients had hypomagnesemia. 59.5.1% had hypocalcemia and 41.9% of had combined low level of Ca+2 and Mg+2 (P = 0.004). Conclusions: Causes of hypocalcemia and hypomagnesemia following thyroidectomy is of multi factorial related mainly to Ca+2, Mg+2 interaction in relation to PTH level.\",\"PeriodicalId\":388688,\"journal\":{\"name\":\"Saudi Journal of Laparoscopy\",\"volume\":\"58 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Saudi Journal of Laparoscopy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/sjl.sjl_10_20\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Saudi Journal of Laparoscopy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/sjl.sjl_10_20","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Hypomagnesemia following thyroidectomy: Prospective observational - Pilot study
Background: Magnesium plays a role in the active transport of calcium (Ca+2) and potassium ions across cell membranes. Most of Mg+2 is intracellular or in the bone <1% is in the blood serum. Post thyroidectomy, hypoparathyroidism leads to acute hypocalcemia that leads to hypomagnesemia. The relation of Ca+2 and magnesium (Mg+2) metabolism is complex and mainly related to the interaction of these cations with parathyroid hormone (PTH) post thyroidectomy. Magnesium is an essential regulator of Ca+2 flux and intracellular action of Ca+2. Hypomagnesemia impairs hypocalcaemia-induced PTH release, which is corrected rapidly after magnesium replacement. Attempting to correct only hypocalcemia may prolong symptoms. It is important to monitor both Ca+2 and Mg+2 levels following thyroidectomy to facilitate prompt resolution of symptoms. The aim: is to highlight the prevalence of hypomagnesemia following thyroidectomy and its association with hypocalcemia which mandate early recognition and treatment to prevent prolongation of hypocalcemia and permanent hypoparathyroidism. Methods: Institutional review board was obtained (E20-4615) and posted in ClinicalTrials.gov NCT04351451. Informed consent taken from all patients. This is a prospective open Label observational pilot study in patients who underwent thyroidectomy. The study period was from January 2019 to January 2020. A total of 74 patients with normal renal function. Serum Ca+2, magnesium, phosphate level, and Vitamin D level are all checked preoperatively and in the first postoperative day. Results: Post thyroidectomy 56.8% of patients had hypomagnesemia. 59.5.1% had hypocalcemia and 41.9% of had combined low level of Ca+2 and Mg+2 (P = 0.004). Conclusions: Causes of hypocalcemia and hypomagnesemia following thyroidectomy is of multi factorial related mainly to Ca+2, Mg+2 interaction in relation to PTH level.