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Case Reports in Endocrinology
Volume 2011, Article ID 370583, 5 pages
http://dx.doi.org/10.1155/2011/370583
Case Report

Life-Threatening Hypocalcemia following Subtotal Parathyroidectomy in a Patient with Renal Failure and Previous Roux-en-Y Gastric Bypass Surgery

Betsy Palal,1 Marvin Sinsakul,2 and Sirimon Reutrakul1

1Section of Endcrinology, Department of Medicine, Rush University Medical Center, Chicago, IL 60612, USA
2Section of Nephrology, Department of Medicine, Rush University Medical Center, Chicago, IL 60612, USA

Received 10 September 2011; Accepted 2 October 2011

Academic Editors: L. Meyer and N. Sakane

Copyright © 2011 Betsy Palal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. H. M. Blanck, W. H. Dietz, D. A. Galuska et al., “State-specific prevalence of obesity among adults - United States, 2005,” Morbidity and Mortality Weekly Report, vol. 55, no. 36, pp. 985–988, 2006. View at Google Scholar · View at Scopus
  2. C. T. Merrill, A. Elixhauser et al., “Procedures in U.S. Hospitals, 2003,” Tech. Rep., U.S. Department of Health and Human Services, 2006. View at Google Scholar
  3. L. Sjöström, K. Narbro, C. D. Sjöström et al., “Effects of bariatric surgery on mortality in Swedish obese subjects,” New England Journal of Medicine, vol. 357, no. 8, pp. 741–752, 2007. View at Publisher · View at Google Scholar · View at Scopus
  4. T. D. Adams, R. E. Gress, S. C. Smith et al., “Long-term mortality after gastric bypass surgery,” New England Journal of Medicine, vol. 357, no. 8, pp. 753–761, 2007. View at Publisher · View at Google Scholar · View at Scopus
  5. D. Heber, F. L. Greenway, L. M. Kaplan, E. Livingston, J. Salvador, and C. Still, “Endocrine and nutritional management of the post-bariatric surgery patient: an endocrine society clinical practice guideline,” Journal of Clinical Endocrinology and Metabolism, vol. 95, no. 11, pp. 4823–4843, 2010. View at Publisher · View at Google Scholar · View at Scopus
  6. K. Dolan, M. Hatzifotis, L. Newbury, and G. Fielding, “A comparison of laparoscopic adjustable gastric banding and biliopancreatic diversion in superobesity,” Obesity Surgery, vol. 14, no. 2, pp. 165–169, 2004. View at Publisher · View at Google Scholar · View at Scopus
  7. R. D. Bloomberg, A. Fleishman, J. E. Nalle, D. M. Herron, and S. Kini, “Nutritional deficiencies following bariatric surgery: whave we learned?” Obesity Surgery, vol. 15, no. 2, pp. 145–154, 2005. View at Publisher · View at Google Scholar · View at Scopus
  8. R. E. Brolin, L. B. LaMarca, H. A. Kenler et al., “Malabsorptive gastric bypass in patients with superobesity,” Journal of Gastrointestinal Surgery, vol. 6, no. 2, pp. 195–203, 2002. View at Publisher · View at Google Scholar · View at Scopus
  9. N. Hamoui, K. Kim, G. Anthone, P. F. Crookes, S. R. Klein, and C. W. Deveney, “The significance of elevated levels of parathyroid hormone in patients with morbid obesity before and after bariatric surgery,” Archives of Surgery, vol. 138, no. 8, pp. 891–897, 2003. View at Publisher · View at Google Scholar · View at Scopus
  10. L. Newbury, K. Dolan, M. Hatzifotis, N. Low, and G. Fielding, “Calcium and vitamin D depletion and elevated parathyroid hormone following biliopancreatic diversion,” Obesity Surgery, vol. 13, no. 6, pp. 893–895, 2003. View at Publisher · View at Google Scholar · View at Scopus
  11. G. H. Slater, C. J. Ren, N. Siegel et al., “Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery,” Journal of Gastrointestinal Surgery, vol. 8, no. 1, pp. 48–55, 2004. View at Publisher · View at Google Scholar · View at Scopus
  12. F. Triponez, O. H. Clark, Y. Vanrenthergem, and P. Evenepoel, “Surgical treatment of persistent hyperparathyroidism after renal transplantation,” Annals of Surgery, vol. 248, no. 1, pp. 18–30, 2008. View at Publisher · View at Google Scholar · View at Scopus
  13. A. Fine and J. Zacharias, “Calciphylaxis is usually non-ulcerating: risk factors, outcome and therapy,” Kidney International, vol. 61, no. 6, pp. 2210–2217, 2002. View at Publisher · View at Google Scholar · View at Scopus
  14. L. R. Essary and M. R. Wick, “Cutaneous calciphylaxis: an underrecognized clinicopathologic entity,” American Journal of Clinical Pathology, vol. 113, no. 2, pp. 280–287, 2000. View at Google Scholar · View at Scopus
  15. J. M. Johnson, J. W. Maher, E. J. DeMaria, R. W. Downs, L. G. Wolfe, and J. M. Kellum, “The long-term effects of gastric bypass on vitamin D metabolism,” Annals of Surgery, vol. 243, no. 5, pp. 701–704, 2006. View at Publisher · View at Google Scholar · View at Scopus
  16. C. De Prisco and S. N. Levine, “Metabolic bone disease after gastric bypass surgery for obesity,” American Journal of the Medical Sciences, vol. 329, no. 2, pp. 57–61, 2005. View at Publisher · View at Google Scholar · View at Scopus
  17. L. V. Crowley, J. Seay, and G. Mullin, “Late effects of gastric bypass for obesity,” American Journal of Gastroenterology, vol. 79, no. 11, pp. 850–860, 1984. View at Google Scholar · View at Scopus
  18. M. Milas and C. J. Weber, “Near-total parathyroidectomy is beneficial for patients with secondary and tertiary hyperparathyroidism,” Surgery, vol. 136, no. 6, pp. 1252–1260, 2004. View at Publisher · View at Google Scholar · View at Scopus
  19. S. C. Pitt, R. S. Sippel, and H. Chen, “Secondary and tertiary hyperparathyroidism, state of the art surgical management,” Surgical Clinics of North America, vol. 89, no. 5, pp. 1227–1239, 2009. View at Publisher · View at Google Scholar · View at Scopus
  20. S. Li, Y. W. Chen, Y. Peng, R. N. Foley, and W. L. S. Peter, “Trends in parathyroidectomy rates in US hemodialysis patients from 1992 to 2007,” American Journal of Kidney Diseases, 2010. View at Publisher · View at Google Scholar · View at Scopus
  21. E.-R. Gagné, P. Ureña, S. Leite-Silva et al., “Short- and long-term efficacy of total parathyroidectomy with immediate autografting compared with subtotal parathyroidectomy in hemodialysis patients,” Journal of the American Society of Nephrology, vol. 3, no. 4, pp. 1008–1017, 1992. View at Google Scholar
  22. M. Rothmund, P. K. Wagner, and C. Schark, “Subtotal parathyroidectomy versus total parathyroidectomy and autotransplantation in secondary hyperparathyroidism: a randomized trial,” World Journal of Surgery, vol. 15, no. 6, pp. 745–750, 1991. View at Google Scholar · View at Scopus
  23. S. Ockert, F. Willeke, A. Richter et al., “Total parathyroidectomy without autotransplantation as a standard procedure in the treatment of secondary hyperparathyroidism,” Langenbeck's Archives of Surgery, vol. 387, no. 5-6, pp. 204–209, 2002. View at Publisher · View at Google Scholar · View at Scopus
  24. R. Roy and J. A. Lee, “Calciphylaxis due to hyperparathyroidism,” Endocrine Practice, vol. 17, supplement 1, pp. 54–56, 2011. View at Publisher · View at Google Scholar
  25. J. M. Moffett and J. Suliburk, “Parathyroid autotransplantation,” Endocrine Practice, vol. 17, supplement 1, pp. 83–89, 2011. View at Publisher · View at Google Scholar
  26. M. A. Guerrero, D. B. Evans, J. E. Lee et al., “Viability of cryopreserved parathyroid tissue: when is continued storage versus disposal indicated?” World Journal of Surgery, vol. 32, no. 5, pp. 836–839, 2008. View at Publisher · View at Google Scholar · View at Scopus
  27. S. Borot, V. Lapierre, B. Carnaille, P. Goudet, and A. Penfornis, “Results of cryopreserved parathyroid autografts: a retrospective multicenter study,” Surgery, vol. 147, no. 4, pp. 529–535, 2010. View at Publisher · View at Google Scholar · View at Scopus
  28. D. Carneiro-Pla, “Contemporary and practical uses of intraoperative parathyroid hormone monitoring,” Endocrine Practice, vol. 17 Suppl 1, pp. 44–53, 2011. View at Publisher · View at Google Scholar
  29. S. C. Pitt, R. Panneerselvan, H. Chen, and R. S. Sippel, “Secondary and tertiary hyperparathyroidism: the utility of ioPTH monitoring,” World Journal of Surgery, vol. 34, no. 6, pp. 1343–1349, 2010. View at Publisher · View at Google Scholar · View at Scopus
  30. T. Weber, M. Zeier, U. Hinz, T. Schilling, and M. W. Büchler, “Impact of intraoperative parathyroid hormone levels on surgical results in patients with renal hyperparathyroidism,” World Journal of Surgery, vol. 29, no. 9, pp. 1176–1179, 2005. View at Publisher · View at Google Scholar · View at Scopus
  31. Y. Ikeda, H. Kurihara, N. Morita, R. Miyabe, and H. Takami, “Significance of Monitoring Bio-Intact PTH (1-84) During Parathyroidectomy for Secondary Hyperparathyroidism,” Journal of Surgical Research, vol. 139, no. 1, pp. 83–87, 2007. View at Publisher · View at Google Scholar · View at Scopus
  32. R. N. Saunders, R. Karoo, M. S. Metcalfe, and M. L. Nicholson, “Four gland parathyroidectomy without reimplantation in patients with chronic renal failure,” Postgraduate Medical Journal, vol. 81, no. 954, pp. 255–258, 2005. View at Publisher · View at Google Scholar · View at Scopus
  33. M. L. Durr, J. R. Saunders, J. A. Califano, R. P. Tufano, W. M. Koch, and P. K. Ha, “Severe hypocalcemia complicating thyroid surgery after Roux-en-Y gastric bypass procedure,” Archives of Otolaryngology - Head and Neck Surgery, vol. 135, no. 5, pp. 507–510, 2009. View at Publisher · View at Google Scholar · View at Scopus
  34. M. Manco, G. Nanni, V. Tondolo et al., “Hypocalcemia complicating near-total thyroidectomy in patients with coexisting lipid malabsorption due to biliopancreatic diversion,” Obesity Surgery, vol. 14, no. 10, pp. 1429–1434, 2004. View at Publisher · View at Google Scholar · View at Scopus
  35. P. M. Rojas-Marcos, M. A. Rubio, W. I. Kreskshi, L. Cabrerizo, and A. Sánchez-Pernaute, “Severe hypocalcemia following total thyroidectomy after biliopancreatic diversion,” Obesity Surgery, vol. 15, no. 3, pp. 431–434, 2005. View at Google Scholar · View at Scopus
  36. S. M. Pietras and M. F. Holick, “Refractory hypocalcemia following near-total thyroidectomy in a patient with a prior roux-en-y gastric bypass,” Obesity Surgery, vol. 19, no. 4, pp. 524–526, 2009. View at Publisher · View at Google Scholar · View at Scopus
  37. K. K. Winer, C. W. Ko, J. C. Reynolds et al., “Long-term treatment of hypoparathyroidism: a randomized controlled study comparing parathyroid hormone-(1-34) versus calcitriol and calcium,” Journal of Clinical Endocrinology and Metabolism, vol. 88, no. 9, pp. 4214–4220, 2003. View at Publisher · View at Google Scholar · View at Scopus
  38. K. K. Winer, N. Sinaii, J. Reynolds, D. Peterson, K. Dowdy, and G. B. Cutler, “Long-term treatment of 12 children with chronic hypoparathyroidism: a randomized trial comparing synthetic human parathyroid hormone 1-34 versus calcitriol and calcium,” Journal of Clinical Endocrinology and Metabolism, vol. 95, no. 6, pp. 2680–2688, 2010. View at Publisher · View at Google Scholar · View at Scopus
  39. M. I. Khan, S. G. Waguespack, and M. I. Hu, “Medical management of postsurgical hypoparathyroidism,” Endocrine Practice, vol. 17, supplement 1, pp. 18–25, 2011. View at Publisher · View at Google Scholar