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

By
Roly Misael Ramos Zenteno ,
Roly Misael Ramos Zenteno

Médico Residente de medicina crítica y terapia intensiva del Hospital Obrero Nro. 2 de la Caja Nacional de Salud. Cochabamba, Bolivia

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Rommer Alex Ortega Martinez ,
Rommer Alex Ortega Martinez

Medico internista e intensivista. Coordinador de investigación clínica en la Universidad privada del Valle. Hospital Obrero Nro. 2 de la Caja Nacional de Salud. Cochabamba, Bolivia

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Lineth Beatriz Nogales Grageda ,
Lineth Beatriz Nogales Grageda

Cirujano general; cirugía cabeza y cuello. Hospital Obrero Nro. 2 de la Caja Nacional de Salud. Cochabamba, Bolivia

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Abstract

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.

How to Cite

1.
Ramos Zenteno RM, Ortega Martinez RA, Nogales Grageda LB. Severe hypocalcemia, an atypical presentation after thyroid cancer surgery, about a case. Salud, Ciencia y Tecnología - Serie de Conferencias [Internet]. 2024 Apr. 9 [cited 2024 Jun. 13];3:680. Available from: https://conferencias.saludcyt.ar/index.php/sctconf/article/view/680

The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.

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