Refractory hypocalcemia following near-total thyroidectomy in a patient with a prior roux-en-y gastric bypass

Abstract  Patients undergoing malabsorptive weight-loss procedures are at increased risk of calcium and vitamin D deficiency. Thyroidectomy
carries the risk of both immediate and long-term hypocalcemia. Here we describe a patient who underwent Roux-en-Y gastric
bypass (RYGB) and subsequent near-total thyroidectomy and then developed refractory hypocalcemia. Serum calcium reached a
nadir of 6.1 mg/dl despite aggressive therapy with oral and IV calcium, calcitriol (1,25(OH)2D3), and IV magnesium sulfate. One year later, the patient has permanent hypoparathyroidism and requires very high doses of
calcium, vitamin D, and calcitriol to prevent symptomatic hypocalcemia. Providers should be aware that malabsorption of calcium
and vitamin D after RYGB may complicate patient management after thyroidectomy.

Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11695-008-9614-8Authors
Sara M. Pietras, Boston University School of Medicine, Boston Medical Center Section of Endocrinology, Diabetes and Nutrition 715 Albany Street, M-1013 Boston MA 02118-2393 USAMichael F. Holick, Boston University School of Medicine, Boston Medical Center Section of Endocrinology, Diabetes and Nutrition 715 Albany Street, M-1013 Boston MA 02118-2393 USA

Journal Obesity SurgeryOnline ISSN 1708-0428Print ISSN 0960-8923 (Source: Obesity Surgery)  MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.