The complex role of post-operative magnesium on the long term serum calcium and parathyroid hormone levels in patients undergoing total and near-total thyroidectomy

Authors

  • Sana Viqar Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
  • Tasleem Akhtar Department of Vascular Surgery, Russells Hall Hospital, Dudley, United Kingdom
  • Nadeem Ikram Department of Pathology, Benazir Bhutto Hospital, Rawalpindi, Pakistan
  • Naeem Zia Department of Surgery, Benazir Bhutto Hospital, Rawalpindi, Pakistan

DOI:

https://doi.org/10.47391/JPMA.4681

Abstract

Objectives: To assess the role of hypomagnesaemia in the development of permanent hypocalcemia following thyroidectomy.

Method: The prospective cohort study was conducted from April 3, 2017, to January 2, 2020, at Surgical Unit 1, Benazir Bhutto Hospital, Rawalpindi, Pakistan, and comprised patients of either gender undergoing total and near total thyroidectomy. Post-operative calcium and magnesium levels were noted, and the patients were followed up after 6 month when fasting serum calcium, magnesium and parathyroid hormone levels were checked. Signs and symptoms of hypocalcaemia were noted. Data was analysed using SPSS 22.

Results: Out of the 62 patients followed up, 57 were females (91.9%) and 5 males (8.1%). The overall mean age was 38.5 ± 12.1 years Post-operative hypomagnesaemia was seen in 6(9.8%) patients and none developed follow-up hypocalcaemia. Post-operative magnesium levels were significantly negatively correlated with follow-up parathyroid hormone level (p=0.006). Fall in magnesium post-operatively and follow-up magnesium were positively correlated with follow-up parathyroid hormone (p<0.05). Permanent hypocalcaemia was seen in 7(11.4%) patients and it was significantly associated with pre-operative and post-operative calcium levels, post-operative symptoms of hypocalcaemia and readmission for hypocalcaemia after discharge (p<0.05). Follow-up hypomagnesaemia was significantly associated with follow-up hypocalcaemia (p=0.024) and follow-up symptoms of hypocalcaemia (p=0.031).

Conclusion: Acute development of mild hypomagnesaemia post-operatively may be beneficial in early positive feedback for parathyroid hormone secretion.

Key Words: Magnesium, Calcium, PTH, Thyroidectomy, Post-operative, Follow-up hypomagnesaemia, Permanent hypocalcaemia.

Author Biographies

Sana Viqar, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan

Postgraduate trainee, General Surgery, Pakistan Institute of Medical Sciences, Islamabad

Benazir Bhutto Hospital, Rawalpindi

Rawalpindi Medical University, Rawalpindi

Tasleem Akhtar, Department of Vascular Surgery, Russells Hall Hospital, Dudley, United Kingdom

Clinical fellow, Vascular Surgery, Russells Hall Hospital, Dudley, UK

Senior Registrar, General Surgery, Benazir Bhutto Hospital, Rawalpindi, Pakistan (During the course of study)

Nadeem Ikram, Department of Pathology, Benazir Bhutto Hospital, Rawalpindi, Pakistan

Associate Professor, Department of Pathology, Benazir Bhutto Hospital, Rawalpindi, Pakistan

Naeem Zia, Department of Surgery, Benazir Bhutto Hospital, Rawalpindi, Pakistan

Professor and Head of department, Surgical unit 1, Benazir Bhutto Hospital, Rawalpindi, Pakistan

 

Published

2022-11-15

How to Cite

Sana Viqar, Tasleem Akhtar, Nadeem Ikram, & Naeem Zia. (2022). The complex role of post-operative magnesium on the long term serum calcium and parathyroid hormone levels in patients undergoing total and near-total thyroidectomy. Journal of the Pakistan Medical Association, 72(12), 2432–2437. https://doi.org/10.47391/JPMA.4681

Issue

Section

Research Article