Severe hypocalcemia, an atypical presentation after thyroid cancer surgery, about a case

• Ramos Zenteno, Roly Misael ^[2] ; Ortega Martinez, Rommer Alex ^[1]
  1. [1] Universidad Privada del Valle

     Universidad Privada del Valle

     Bolivia

     
  2. [2] Hospital Obrero Nro. 2 de la Caja Nacional de Salud. Cochabamba, Bolivia
• Localización: Salud, Ciencia y Tecnología - Serie de Conferencias, ISSN-e 2953-4860, Nº. 3, 2024 (Ejemplar dedicado a: Salud, Ciencia y Tecnología - Serie de Conferencias)
• Idioma: inglés
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• Resumen

  • Hypoparathyroidism, secondary to postoperative thyroid cancer, is characterized by hypocalcemia, hyperphosphatemia, and hypercalciuria due to low concentrations of parathyroid hormone. The prevalence in the United States is 23 to 37 cases/100,000 people/year. Complications develop in 78 % of cases after cervical surgery; 75 % resolve spontaneously in the first 6 months, while the remaining 25 % resolve permanently; no incidence data were obtained in Bolivia. Treatment requires long-term oral calcium with citrate, calcium carbonate, and vitamin D analogs (calcitriol and alfacalcidol); in complex cases, calcium can be used intravenously (calcium gluconate); Some patients do not respond to standard treatment. In this way, the unusual clinical case of a 38-year-old male patient with a history of papillary thyroid carcinoma, post-total thyroidectomy, with a clinical picture of 48 hours of evolution characterized by pain at the cervical level, associated with a Trosseau sign, is presented. (+) and frank signs of respiratory distress with laryngeal spasm, which required management in the intensive care unit (ICU), correction of severe hypocalcemia, with calcium gluconate IV and calcium plus vitamin D PO; presenting an optimal evolution, graduating on the fourth day; He was subsequently discharged from the hospital two weeks later in good general condition