Our Summary

This research paper focuses on a condition called “hungry bone syndrome” (HBS), which can occur after surgery to remove the parathyroid glands. The parathyroid glands regulate calcium in the body, and if they’re removed, the body’s calcium level can drop significantly. This can cause a range of symptoms and health problems, and is often seen in patients requiring regular dialysis.

Scientists have noticed that this syndrome is more common in patients with a secondary issue with their parathyroid glands, rather than a primary one. They’ve also found that certain signs - like changes in bone on an X-ray, high levels of certain substances in the blood, and a large number of specific cells on a bone biopsy - can help to predict which patients are more likely to develop this condition.

The treatment for HBS typically involves taking high doses of oral calcium and a medication called calcitriol. It’s also suggested that a medication called pamidronate might be able to prevent the syndrome if given before surgery.

The paper calls for more research into how often HBS occurs, how it affects patients’ health and survival, and whether medications called bisphosphonates could help prevent it.

FAQs

  1. What is “hungry bone syndrome” and how is it related to parathyroidectomy?
  2. What are some signs that a patient might be more likely to develop hungry bone syndrome after parathyroidectomy?
  3. What is the typical treatment for hungry bone syndrome, and how might it be prevented?

Doctor’s Tip

A helpful tip a doctor might tell a patient about parathyroidectomy and the risk of developing hungry bone syndrome is to make sure to follow all post-operative instructions closely, including taking prescribed medications as directed. It’s also important to stay in communication with your healthcare provider and report any concerning symptoms or changes in your health. Lastly, make sure to attend all follow-up appointments to monitor your calcium levels and overall well-being.

Suitable For

Overall, patients who are recommended for parathyroidectomy are those who have hyperparathyroidism, a condition in which the parathyroid glands produce too much parathyroid hormone (PTH). This can lead to high levels of calcium in the blood, causing symptoms such as fatigue, weakness, bone pain, and kidney stones. Parathyroidectomy is often recommended for patients with primary hyperparathyroidism, in which the problem originates in the parathyroid glands themselves.

Timeline

  • Before parathyroidectomy:
  1. Patients may experience symptoms of hyperparathyroidism, such as fatigue, weakness, bone pain, kidney stones, and high levels of calcium in the blood.
  2. Patients undergo diagnostic tests, such as blood tests, imaging studies, and possibly a biopsy of the parathyroid gland.
  3. Surgery is scheduled to remove the affected parathyroid gland or glands.
  4. Patients may receive counseling on the potential risks and complications of surgery, including the risk of developing hungry bone syndrome.
  • After parathyroidectomy:
  1. Patients undergo surgery to remove the affected parathyroid gland or glands.
  2. Patients may experience a sudden drop in calcium levels in the blood, leading to symptoms such as muscle cramps, tingling in the hands and feet, and changes in mental status.
  3. Patients are closely monitored for signs of hungry bone syndrome, such as low calcium levels, high phosphate levels, and changes in bone on imaging studies.
  4. Treatment for hungry bone syndrome may include oral calcium supplements, calcitriol, and possibly pamidronate to prevent complications.
  5. Patients may require long-term monitoring of calcium levels and bone health to prevent recurrence of symptoms.

Overall, the timeline for a patient before and after parathyroidectomy involves diagnosis of hyperparathyroidism, surgery to remove the affected parathyroid gland, and close monitoring for potential complications such as hungry bone syndrome. Treatment for hungry bone syndrome typically involves calcium and vitamin D supplements, with possible use of medications to prevent bone loss.

What to Ask Your Doctor

  1. What is a parathyroidectomy and why is it necessary in my case?
  2. What are the potential risks and complications of a parathyroidectomy, including the risk of developing hungry bone syndrome?
  3. What are the signs and symptoms of hungry bone syndrome that I should watch out for after surgery?
  4. How is hungry bone syndrome typically treated and managed?
  5. Are there any specific tests or monitoring that should be done to detect or prevent hungry bone syndrome?
  6. Are there any medications or supplements that I should take before or after surgery to reduce the risk of developing hungry bone syndrome?
  7. How long will it take for my body to regulate calcium levels after surgery, and what can I expect in terms of recovery and healing?
  8. Are there any dietary or lifestyle changes that I should make to support my recovery and prevent complications?
  9. What is the long-term outlook for someone who has had a parathyroidectomy and is at risk for hungry bone syndrome?
  10. Are there any support groups or resources available for patients who have undergone a parathyroidectomy and are dealing with the potential complications of hungry bone syndrome?

Reference

Authors: Jain N, Reilly RF. Journal: Curr Opin Nephrol Hypertens. 2017 Jul;26(4):250-255. doi: 10.1097/MNH.0000000000000327. PMID: 28375869