J.Jpn. Surg. Soc.. 82(2): 130-138, 1981

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Original article

STUDIES ON ETIOLOGY OF POSTOPERATIVE TRANSIENT TETANY FOLLOWING THYROIDECTOMY FOR HYPERTHYROIDISM

Although it is widely accepted that the postoperative tetany following thyroidectomy may be due to parathyroid damage, there seems to be some differences between transient tetany after thyroidectomy for hyperthyroidism and permanent tetany after thyroidectomy for thyroid cancer. The present study was undertaken to elucidate the mechanism of the postoperative transient tetany in hyperthyroidism.
The serum levels of Ca, P and A1-p were compared in two groups of tetanic and non-tetanic patients after subtotal thyroidectomy for hyperthyroidism. The plasma levels of parathyroid hormone (PTH) and calcitonin (CT) were assessed not only preoperatively but also serially surgery. The parathyroid functions were also compared in the preoperative and postoperative subjects. In addition, the CT tolerance test was performed in the thyroidectomized patients.
The tetanic group showed significantly higher serum P and A1-p levels than the non-tetanic group (P＜0.02 and P＜0.01, respectively). The PTH levels were relatively low throughout the preoperative and postoperative periods. Meanwhile, the CT values started to rise during the operation. No apparent difference was observed in the parathyroid functions between preoperative and postoperative subjects. Furthermore, there also existed no significant difference on the specific response to the exogenous CT between thyroidectomized patients and normal persons, although the untreated hyperthyroid patients demonstrated a stronger response than did normal persons.
Based on these data, it could be concluded that both active metabolism of bones and CT release will play a major role in the occurrence of postoperative transient tetany in hyperthyroidism.

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