Hypercalcemia following Alfacalcidol for Post-Surgical Hypoparathyroidism-An Underestimated Complication?
Journal Title: Journal of Endocrinology and Diabetes - Year 2015, Vol 2, Issue 5
Abstract
Background: Post operative hypocalcemia is a common complication of thyroid and parathyroid surgery and is treated with calcium and/or active Vitamin D supplements, such as alfacalcidol. Although reportedly uncommon, we observed several cases of alfacalcidol induced hypercalcemia within a short period of time. Objective: To determine the incidence alfacalcidol induced hypercalcemia in the post-surgical setting and explore factors predisposing to this complication. Patients and Methods: This was a retrospective cohort study. All prescriptions for alfacalcidol for post-surgical hypocalcemia in a three-year period were reviewed; and clinical and biochemical characteristics of these patients were ascertained. The main outcome measure was the occurrence of hypercalcemia. Potential risk factors for hypercalcemia were also investigated. Results: Of 61 patients prescribed alfacalcidol for post-surgical hypocalcemia, 17(27.9%) developed hypercalcemia. Of these, one patient had a significant clinical event. Exploratory analyses did not identify any potential factors that could predict the risk or severity of this complication. Conclusions: This report serves to raise awareness of the risk of alfacalcidol induced hypercalcemia in patients with post-surgical hypoparathyroidism; which is higher than previously estimated. Given the inability to predict hypercalcemia and the variability of parathyroid recovery after surgery, serum calcium should be monitored regularly and attempts should be made to gradually withdraw active Vitamin D supplements for all patients with postsurgical hypoparathyroidism.
Authors and Affiliations
Sabapathy P Balasubramanian, Catherine Leng, Glen Charlesworth, Emma Nofal
Keywords
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- EP ID EP333331
- DOI 10.15226/2374-6890/2/5/00135
- Views 112
- Downloads 0
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