Introduction: HypoPTH is an uncommon disorder, mostly due to anterior neck surgery. The prevalence of HypoPTH has been studied in surgical series and registries, (USA, Denmark and Hungary) where only a minority of patients has HypoPTH due to non-surgical causes. In Spain data on PO HypoPTH in endocrinologist clinical practice has been published recently. The aim of this study was to establish the prevalence of chronic PO HypoPTH in Bilbao area, with a population 2019: 346,843.
Subjects and methods: In Spain, patients who have been prescribed a drug in the public Health Service are recorded in a regional prescription database. Data were obtained by searching for patients on both calcitriol and levothyroxine between 2012 and 2019. For all identified patients the individual medical record was reviewed. Only patients who underwent neck surgery (mainly total thyroidectomy) were included in the study. For the analysis, chronic PO HypoPTH was defined as hypocalcaemia with inadequate low PTH levels following neck surgery that necessitated treatment with calcitriol for more than 1 year.
Results: 436 out of 489 patients met inclusion criteria. 110 patients were found to have chronic POHypoPTH, giving a prevalence of 31.7/100,000 inhabitants.
Among patients operated on in our center before 2012, 56 developed chronic HypoPTH. No data is available on the total number of surgeries performed during this period of time. 119 thyroid surgeries performed before 2012 are on record. 63/119 patients develop transient HypoPTH. Some of them were taking calcitriol although calcium and PTH levels were normalized. Between 2012 and 2019, 1096 patients underwent thyroid surgery (1,021 total thyroidectomy, 214 central/lateral lymphadenectomy additionally) in our center. Among those, 317 (31%) resulted in HypoPTH, with 269 (26.3%) of these cases being transient, and 48 (4.7%) chronic.
Conclusion: – The estimated prevalence of chronic PO HipoPTH in the population of Bilbao is similar to other areas related in the literature.
– The prevalence of PO hypoPTH in our center since 2012 is high 31% but in line with other surgical series, being chronic in 4.7%.
– No differences were found between surgeries for benign or malignant disease.
– Data published in endocrinologist clinical practice show higher rates: 48.3% transient and 14.5% chronic. These differences are due to the methodologies used.
– Although recovery from chronic HypoPTH is rare, patients should be monitored forserum PTH levels so that unnecessary treatments can be avoided.
05 Sep 2020 - 09 Sep 2020