Endocrine Abstracts (2011) 26 P516

Hungry bone syndrome following parathyroidectomy

Neslihan Soysal Atile, Betül Ekiz Bilir & Sibel Güldiken


Internal Medicine, Endocrinology Division, Trakya University Medical Faculty, Edirne, Turkey.


Aim: Hypocalcemia is a common problem after parathyroidectomy but is generally transient. In some cases the postoperative hypocalcemia is severe and prolonged despite normal or even elevated levels of parathyroid hormone (PTH). This phenomenon, called the hungry bone syndrome (HBS), occurs due to sudden withdrawal of PTH leading to a marked net increase in bone uptake of Ca, P, and Mg. We aimed to evaluate predictive factors for HBS development after parathyroidectomy.

Material and method: Forty-four patients who undergone surgical resection for parathyroid adenoma were evaluated retrospectively. Age, gender and preoperative serum levels of corrected Ca, P, iPTH, ALP, urea and creatinine were recorded. We accepted HBS diagnosis as the serum calcium concentration below normal limits for at least 1 week after parathyroidectomy.

Results: We divided the patients into two groups as HBS (n=13) and non-HBS (n=31). There was no difference between the groups in terms of age and gender. Serum Ca and ALP levels of groups were similar. Serum P, iPTH, urea and creatinine levels were higher in HBS group than non-HBS group (P<0.05, P<0.01, P<0.05, P<0.05 respectively). 6 of 13 (46.2%) patients with HBS had chronic renal failure (CRF), whereas CRF percentage was just 6% in non-HBS group (P<0.01).

Conclusion: We suggest that CRF is an important risk factor for HBS development after parathyroidectomy.

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