Postoperative calcium levels may predict permanent hypoparathyroidism in children after thyroid surgery

Younger age and the presence of extrathyroidal extension (ETE) are significant risk factors for developing permanent hypoparathyroidism (HPT) in children after total thyroidectomy, according to a study. Postoperative calcium levels may also serve as a key predictor for permanent HPT.

The retrospective review examined 70 pediatric patients who underwent thyroid surgery.

Overall, 23% of patients developed postoperative HPT, with 14% experiencing transient HPT and 9% developing permanent HPT. Factors associated with an increased risk of HPT included central compartment neck dissection, larger nodular size, malignant disease, and ETE.

Permanent HPT was specifically linked to ETE (P = 0.034) and younger age at diagnosis, with a median age of 10.5 years for affected patients compared to 14.5 years for others (P = 0.035). In addition, postoperative calcium indices, including initial and minimal calcium levels and their decline after surgery, were associated with permanent HPT.

Reference
Ritter A, Reuven Y, Tsur N, et al. Potential determinants and predictors of hypoparathyroidism after total thyroidectomy in pediatric patients. Eur Arch Otorhinolaryngol. 2024;doi: 10.1007/s00405-024-09152-4. Epub ahead of print. PMID: 39702807.