Hungry Bone Syndrome (HBS) in Patients Operated for Primary Hyperparathyroidism (PHPT): A Six-Year Experience

Authors

  • Rhoda Zyra M. Padilla-Baraoidan Department of Medicine Section of Endocrinology, Diabetes, and Metabolism Makati Medical Center
  • Maria Jocelyn Capuli-Isidro Department of Medicine Section of Endocrinology, Diabetes, and Metabolism Makati Medical Center
  • Beinjerinck Ivan B. Cudal Department of Medicine Section of Endocrinology, Diabetes, and Metabolism Makati Medical Center
  • Ayezl A. Embestro-Pontillas Department of Medicine Section of Endocrinology, Diabetes, and Metabolism Makati Medical Center

DOI:

https://doi.org/10.32412/pjohns.v32i2.59

Keywords:

hungry bone syndrome, Philippines, primary hyperparathyroidism

Abstract

Objective:      To review cases of adult patients who develop Hungry Bone Syndrome (HBS) after parathyroidectomy for Primary Hyperparathyroidism (PHPT) in a tertiary care center in the Philippines and describe the clinical features, pre-operative preventive measures done, and risk factors for HBS.

Methods: Study Design:            Retrospective case note review Setting:                       Tertiary Private Hospital Participants:              Chart review of adult Filipino patients who underwent parathyroidectomy for PHPT at Makati Medical Center from January 2011 to December 2016 was conducted and evaluated according to the inclusion and exclusion criteria. Medical information obtained included clinical parameters, biochemical results, operation performed, pathology, length of hospital stay and complications if with any.

Results:          From among 20 adult Filipino patients (mean age 55 years; 13, 65% female) who underwent parathyroidectomy for PHPT, HBS was found in 7 (35%). Most common pre-operative symptoms of hypercalcemia were musculoskeletal complaints. To prevent HBS, all were hydrated prior to surgery, while some were given bisphosphonates and diuretics. The most common parathyroid gland imaging used for pre-procedure localization was Tc 99m Sestamibi scan with single photon emission computed tomography (SPECT) and 19 (95%) had parathyroid adenoma on post-operative histopathologic report. Among biochemical and clinical factors that may be risk factors for HBS, those with HBS had significantly lower pre-operative 25-hydroxyvitamin D, higher BUN, phosphate and alkaline phosphatase (ALP) than those without HBS. Of these, only ALP showed significant association with HBS (OR = 107.17, p = <0.0001). Length of hospital stay was longer among those with HBS, although not statistically significant.

Conclusion:    Knowledge on post-parathyroidectomy HBS for PHPT may aid clinicians on pre-operative prevention and post-operative monitoring. Thirty-five percent (7) of our patients presented with HBS post-parathyroidectomy for PHPT from 2011 to 2016. An abnormal ALP level pre-operatively may be a risk factor in developing HBS post-parathyroidectomy for PHPT.

Keywords: primary hyperparathyroidism, hungry bone syndrome, Philippines

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Published

2018-07-17

How to Cite

1.
Padilla-Baraoidan RZM, Capuli-Isidro MJ, Cudal BIB, Embestro-Pontillas AA. Hungry Bone Syndrome (HBS) in Patients Operated for Primary Hyperparathyroidism (PHPT): A Six-Year Experience. Philipp J Otolaryngol Head Neck Surg [Internet]. 2018 Jul. 17 [cited 2023 Feb. 6];32(2):11-6. Available from: https://pjohns.pso-hns.org/index.php/pjohns/article/view/59

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