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

Authors：

黄初东 ^1,2 , 胡明 ³ , 李志辉 ¹ , 刘枫 ¹ , 刘雪娟 ¹ , 陈玉娟 ¹

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Keywords：

甲状腺功能亢进; 手术; 骨饥饿综合征

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目的探讨甲状腺功能亢进（简称甲亢）手术后出现骨饥饿综合征的发病机理。方法回顾性分析四川大学华西医院2009年收治的2例甲亢手术后严重低钙患者的临床资料。结果本组2例病例在甲亢手术后均出现了严重低钙血症，1例低镁血症; 2例病例手术前、后骨代谢碱性磷酸酶均有不同程度升高。结论甲亢手术后骨饥饿综合征是多因素造成的临床症状，所以对手术后低钙症状应给予正确分析和判断，并尽可能在问题出现前给予预测和处理。对于甲亢患者和绝经期女性在围手术期给予钙的补充，手术中注意保存甲状旁腺血供是减少骨饥饿综合征的最佳手段，甲亢手术后及时补钙是必要的。

Citation： 黄初东,胡明,李志辉,刘枫,刘雪娟,陈玉娟. Hungry Bone Syndrome Following Hyperthyroidism Operation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(10): 1098-1099. doi: Copy

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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.
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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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