Potestà P, Murolo R, Costantini S, Imperoli G, Giardina F, Guerriero G
III Divisione di Medicina Clinica Valle Fiorita, Ospedale San Filippo Neri, Roma.
Riv Eur Sci Med Farmacol. 1994 Sep-Dec;16(5-6):99-101.
Hypoparathyroidism following neck surgery, mainly thyroidectomy, is not a rare event, well known since many years. Post-surgical hypoparathyroidism may occur in form of two clinical syndromes of different etiology and prognosis. The first disease is a transitory hypoparathyroidism that might spontaneously recover within a few weeks or months. The second disease is a permanent hypoparathyroidism needing a definitive opoterapic treatment. Anyhow in both cases, hypocalcemic symptoms begin always within a short time from surgery, usually after an asymptomatic period elapsing from days to months. Only few cases of hypoparathyroidism clinically conclamate after many years from surgery have been reported. Description of a patient with hypoparathyroidism that became clinically evident thirty years after the thyroid surgery is herewith described. Our findings and review of a few cases reported by medical literature, can suggest a third form of post-surgical hypoparathyroidism with the distinctive feature of a very late beginning, probably following a long period of a latent parathyroid insufficiency.
颈部手术后，主要是甲状腺切除术后发生的甲状旁腺功能减退并非罕见事件，多年来已为人所知。术后甲状旁腺功能减退可能以两种病因和预后不同的临床综合征形式出现。第一种疾病是暂时性甲状旁腺功能减退，可能在几周或几个月内自发恢复。第二种疾病是永久性甲状旁腺功能减退，需要确定性的治疗。无论如何，在这两种情况下，低钙血症症状总是在手术后短时间内开始，通常是在无症状期从几天到几个月后出现。仅有少数甲状旁腺功能减退病例在手术后多年才出现临床症状的报道。本文描述了一例甲状腺手术后30年才出现临床明显症状的甲状旁腺功能减退患者。我们的发现以及对医学文献报道的一些病例的回顾表明，可能存在第三种术后甲状旁腺功能减退形式，其显著特征是发病非常晚，可能是在长期潜在的甲状旁腺功能不全之后。
