Tetany despite normocalcaemia and normomagnesaemia following parathyroidectomy.
نویسندگان
چکیده
Two patients with long-standing hyperparathyroidism due to a parathyroid adenoma are described. Both had severe osteitis fibrosa cystica and a proximal myopathy. Both were treated with alfacalcidol (2 micrograms/day) prior to and following parathyroidectomy, and infused with calcium gluconate following the operation. Plasma total and ionized calcium and magnesium concentrations were maintained within the normal range. However, both developed tetany in the postoperative period in spite of normal ionized calcium and magnesium concentrations. Tetany continued for 4 weeks in one patient and for longer in the other. Prolonged hypercalcaemia may result in a state of neuromuscular excitability following parathyroidectomy even at high normal concentrations of ionized calcium.
منابع مشابه
The Excretion of Calcium and Magnesium after Parathyroidectomy
Within the past few years evidence has gradually accumulated, both direct and indirect, indicating some definite relation, the nature of which is as yet quite obscure, between the kations of calcium salts and certain forms of muscle irritability. The observations recorded may be summarized as follows : ( I ) Abnormal muscular twitchings and contractions may be brought about in an organism by a ...
متن کاملThe Removal of Calcium from the Blood by Dialysis in the Study of Tetany
We may devise a fluid containing practically all the inorganic diffusible constituents of the blood except calcium, and use it to dialyze normal blood in such a way as to remove from it a large part of its calcium. The dialyzed blood when perfused through an isolated extremity produces an extreme hyperexcitability of the nerves quite like that observed in tetany. Since perfusion with blood dial...
متن کاملComplications after parathyroidectomy. Fractures from low calcium and magnesium convulsions.
symptoms are mild, the hypocalcaemia temporary, and treatment is not required. In a few, those with renal disease, bone disease or steatorrhoea, the hypocalcaemia is likely to be severe and need treatment. The routine management of this type of patient has been described by Dent (1962). We have recently studied two patients who had generalised convulsions after parathyroidectomy despite this ro...
متن کاملNeonatal primary hyperparathyroidism masked by vitamin D deficiency.
Neonatal primary hyperparathyroidism is a life threatening disorder that is associated with severe hypercalcaemia, hypotonia, bone demineralization, fractures and respiratory distress. Treatment consists of total parathyroidectomy and without this affected infants will usually die by the age of three months. We report a patient with neonatal primary hyperparathyroidism who survived without frac...
متن کاملIsolated hypomagnesaemia presenting as focal seizures in diabetes mellitus.
Hypomagnesaemia is a well known association of diabetes mellitus; it is often asymptomatic but may manifest as tremor, tetany, delirium, hallucinations, or, when severe, generalised seizures. In such instances it is usually associated with hypocalcaemia. We report on a diabetic patient with severe hypomagnesaemia but normocalcaemia who developed focal seizures that proved refractory to conventi...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Postgraduate medical journal
دوره 63 744 شماره
صفحات -
تاریخ انتشار 1987