Delayed Hypoparathyroidism following Thyroidectomy, a Diagnostic Conundrum: A Report of Three Cases from Sri Lanka

Table 2

Summary of investigations of case 2.

Investigation	Immediately after surgery	1 year after op	5 years after op	12 years after op- 3 months before	12 years after op- current presentation	Normal range
Serum-ionized calcium	1.1 mmol/l	1.2 mmol/l	1.2 mmol/l		0.8 mmo/l	1.12–1.32 mmo/l
Serum phosphate	4.2 mg/dl	3 mg/dl	3.2 mg/dl		4.5 mg/dl	2.7–4.5 mg/dl
Alkaline phosphatase					123 IU/L	44–147 IU/l
24 hour urinary calcium excretion					270 mg/24 hours	100–300 mg/24 hours
24 hour urine phosphate excretion					400 mg/24 hours	500–1500 mg/24 hours
Serum magnesium					0.9 mmol/l	0.85–1.1 mmol/l
Intact PTH					7 pg/ml	10–69 pg/ml
S. 25(OH) vitamin D level					38 ng/ml	30–100 ng/ml
Thyroid stimulation hormone (TSH)		0.056 mIU/L	0.9 mIU/L	17.5 mIU/L	0.7 mIU/l	0.4–4 mIU/l
Free T4 (FT4)				0.4 ng/dl		0.89–1.76 ng/dl