Hungry Bone Syndrome Following Hyperthyroidism Operation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

黃初東 ^1,2 , 胡明 ³ , 李志輝 ¹ , 劉楓 ¹ , 劉雪娟 ¹ , 陳玉娟 ¹

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Keywords：

甲狀腺功能亢進; 手術; 骨饑餓綜合征

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目的探討甲狀腺功能亢進（簡稱甲亢）手術后出現骨饑餓綜合征的發病機理。方法回顧性分析四川大學華西醫院2009年收治的2例甲亢手術后嚴重低鈣患者的臨床資料。結果本組2例病例在甲亢手術后均出現了嚴重低鈣血癥，1例低鎂血癥; 2例病例手術前、后骨代謝堿性磷酸酶均有不同程度升高。結論甲亢手術后骨饑餓綜合征是多因素造成的臨床癥狀，所以對手術后低鈣癥狀應給予正確分析和判斷，并盡可能在問題出現前給予預測和處理。對于甲亢患者和絕經期女性在圍手術期給予鈣的補充，手術中注意保存甲狀旁腺血供是減少骨饑餓綜合征的最佳手段，甲亢手術后及時補鈣是必要的。

Citation： 黃初東,胡明,李志輝,劉楓,劉雪娟,陳玉娟. Hungry Bone Syndrome Following Hyperthyroidism Operation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(10): 1098-1099. doi: Copy

1.	Shane E, Bilezikian JP. Parathyroid carcinoma: a review of 62 patients [J]. Endocr Rev, 1982, 3(2): 218226.
2.	Yano S, Suzuki K, Sumi M, et al. Bone metabolism after cinacalcet administration in patients with secondary hyperparathyroidism [J]. J Bone Miner Metab, 2010, 28(1): 4954.
3.	Jones RM, Davidson CM. Thyrotoxicosis and the hungry bone syndrome: a cause of postoperative tetany [J]. J R Coll Surg Edinb, 1987, 32(1): 2428．.
4.	See AC, Soo KC. Hypocalcaemia following thyroidectomy for thyrotoxicosis [J]. Br J Surg, 1997, 84(1): 9597.
5.	Abu EO, Bord S, Horner A, et al. The expression of thyroid hormone receptors in human bone [J]. Bone, 1997, 21(2): 137142.
6.	Abu EO, Horner A, Teti A, et al. The localization of thyroid hormone receptor mrnas in human bone [J]. Thyroid, 2000, 10(4): 287293.
7.	Bassett JH, O’Shea PJ, Sriskantharajah S, et al. Thyroid hormone excess rather than thyrotropin deficiency induces osteoporosis in hyperthyroidism [J]. Mol Endocrinol, 2007, 21(5): 10951107.
8.	Rosol TJ, Capen CC. Calciumregulating hormones and diseases of abnormal mineral (calcium, phosphorus, magnesium) metabolism//Kaneko JJ, Harvey JW, Bruss ML, eds. Clinical Biochemistry of Domestic Animals [M]. 5th ed. San Diego, California: Academic Press, 1997: 619702.
9.	Dhupa N, Proulx J. Hypocalcemia and hypomagnesemia [J]. Vet Clin North Am Small Anim Pract, 1998, 28(3): 587608.
10.	Hardoff R, Frajewicki V. Bone scintigraphy in hungry bone syndrome following parathyroidectomy [J]. J Nucl Med, 1996, 37(8): 13711373.
11.	Brasier AR, Nussbaum SR. Hungry bone syndrome: clinical and biochemical predictors of its occurrence after parathyroid surgery [J]. Am J Med, 1988, 84(4): 654660.
12.	Morrone LF, Tampoia M, Pansini N, et al. Kinetics of the circulating levels of bone alkaline phosphatase in a case of hungry bone disease following total parathyroidectomy [J]. Ann Ital Med Int, 2004, 19(3): 189192.
13.	Zaidi M, Iqbal J, Blair HC, et al. Paradigm shift in the pathophysiology of postmenopausal and thyrotoxic osteoporosis [J]. Mt Sinai J Med, 2009, 76(5): 474483.
14.	Farese S. The hungry bone syndrome－an update [J]. Ther Umsch, 2007, 64(5): 277280.

1. Shane E, Bilezikian JP. Parathyroid carcinoma: a review of 62 patients [J]. Endocr Rev, 1982, 3(2): 218226.
2. Yano S, Suzuki K, Sumi M, et al. Bone metabolism after cinacalcet administration in patients with secondary hyperparathyroidism [J]. J Bone Miner Metab, 2010, 28(1): 4954.
3. Jones RM, Davidson CM. Thyrotoxicosis and the hungry bone syndrome: a cause of postoperative tetany [J]. J R Coll Surg Edinb, 1987, 32(1): 2428．.
4. See AC, Soo KC. Hypocalcaemia following thyroidectomy for thyrotoxicosis [J]. Br J Surg, 1997, 84(1): 9597.
5. Abu EO, Bord S, Horner A, et al. The expression of thyroid hormone receptors in human bone [J]. Bone, 1997, 21(2): 137142.
6. Abu EO, Horner A, Teti A, et al. The localization of thyroid hormone receptor mrnas in human bone [J]. Thyroid, 2000, 10(4): 287293.
7. Bassett JH, O’Shea PJ, Sriskantharajah S, et al. Thyroid hormone excess rather than thyrotropin deficiency induces osteoporosis in hyperthyroidism [J]. Mol Endocrinol, 2007, 21(5): 10951107.
8. Rosol TJ, Capen CC. Calciumregulating hormones and diseases of abnormal mineral (calcium, phosphorus, magnesium) metabolism//Kaneko JJ, Harvey JW, Bruss ML, eds. Clinical Biochemistry of Domestic Animals [M]. 5th ed. San Diego, California: Academic Press, 1997: 619702.
9. Dhupa N, Proulx J. Hypocalcemia and hypomagnesemia [J]. Vet Clin North Am Small Anim Pract, 1998, 28(3): 587608.
10. Hardoff R, Frajewicki V. Bone scintigraphy in hungry bone syndrome following parathyroidectomy [J]. J Nucl Med, 1996, 37(8): 13711373.
11. Brasier AR, Nussbaum SR. Hungry bone syndrome: clinical and biochemical predictors of its occurrence after parathyroid surgery [J]. Am J Med, 1988, 84(4): 654660.
12. Morrone LF, Tampoia M, Pansini N, et al. Kinetics of the circulating levels of bone alkaline phosphatase in a case of hungry bone disease following total parathyroidectomy [J]. Ann Ital Med Int, 2004, 19(3): 189192.
13. Zaidi M, Iqbal J, Blair HC, et al. Paradigm shift in the pathophysiology of postmenopausal and thyrotoxic osteoporosis [J]. Mt Sinai J Med, 2009, 76(5): 474483.
14. Farese S. The hungry bone syndrome－an update [J]. Ther Umsch, 2007, 64(5): 277280.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Hungry Bone Syndrome Following Hyperthyroidism Operation

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