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

Table 3

Summary of investigations of case 3.

Investigation	Immediately after surgery	1 year after op	5 years after op	13 years after op- current presentation	Normal range
Serum-ionized calcium	1.13 mmol/l	1.2 mmol/l	1.15 mmol/l	0.8 mmo/l	1.12–1.32 mmo/l
Serum phosphate	4.3 mg/dl			4.8 mg/dl	2.7–4.5 mg/dl
Alkaline phosphatase				130 IU/L	44–147 IU/l
24 hour urinary calcium excretion				280 mg/24 hours	100–300 mg/24 hours
24 hour urine phosphate excretion				550 mg/24 hours	500–1500 mg/24 hours
Serum magnesium				1.4 meq/l	1.3–2.1 meq/l
Intact PTH				9 pg/ml	10–69 pg/ml
S. 25(OH) vitamin D level				33 ng/ml	30–100 ng/ml
Thyroid stimulation hormone (TSH)		0.04 mIU/L	0.2 mIU/L	0.4 mIU/l	0.4–4 mIU/l
Free T4 (FT4)				1.4 ng/dl	0.89–1.76 ng/dl