Management of hypocalcemia after modified bilateral radical neck dissection followed with total thyroidectomy: a case report

International Journal of Health Sciences

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Title Management of hypocalcemia after modified bilateral radical neck dissection followed with total thyroidectomy: a case report
 
Creator Arimbawa, I Made
Paramita, Ayu Diah Perdana
Nuaba, I Gde Ardika
Saputra, Herman
 
Subject calcitriol
calcium
hypocalcemia
hypoparathyroidism
hypovitaminosis
 
Description Hypocalcemia is a common complication after total thyroidectomy due to acute hypoparathyroidism post-surgery. The incident varies from 7%-69% depends on the surgery center. The management is divided based on the onset and symptoms. Carpal-pedal spasm, seizure, bronchospasms are the emergency symptoms of hypocalcemia that require administration of intravenous calcium. However, the management of asymptomatic hypocalcemia with oral calcium, vitamin D, and hydrochlorothiazide can be difficult due to wide fluctuations of serum calcium and the risks of complication. Hereby we report a 14-year-old girl with hypocalcemia due to hypoparathyroidism post modified bilateral radical neck dissection and total thyroidectomy. She had papillary thyroid carcinoma and lymph node metastases. After surgery, she developed classic signs of hypocalcemia, numbness in extremities which progressed to cramps. Physical examination revealed chvostek’s sign. Laboratory examination showed the critical value of hypocalcemia with a normal level of albumin, hypoparathyroidism, and hypovitaminosis D. The initial treatment was started by giving intravenous calcium gluconate 10% and calcitriol. Monitoring levels of calcium and phosphate were performed regularly. Calcium level was maintained by giving a high dose of elemental calcium, vitamin D3 and hydrochlorothiazide followed.
 
Publisher Universidad Tecnica de Manabi
 
Date 2021-01-23
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
 
Format application/pdf
 
Identifier http://sciencescholar.us/journal/index.php/ijhs/article/view/654
10.29332/ijhs.v5n1.654
 
Source International journal of health sciences; Vol. 5 No. 1 (2021): Online First; 9-19
2550-696X
2550-6978
 
Language eng
 
Relation http://sciencescholar.us/journal/index.php/ijhs/article/view/654/559
 
Rights Copyright (c) 2021 International journal of health sciences
http://creativecommons.org/licenses/by-nc-nd/4.0
 

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