Changes in Serum Parathyroid Hormone and Timing of Biochemical and Clinical Manifestations After Thyroid Surgery

Authors

• Md Mahbobul HaqueAssistant Professor, Dept. of ENT, General Hospital, Faridpur, Bangladesh Attachment -National Institute of ENT, Tejgaon, Dhaka, Bangladesh
• Rahat Tanvir AnwarAssistant Registrar, Department of Otolaryngology & Head Neck Surgery National Institute of ENT, Tejgaon, Dhaka, Bangladesh.
• Md Rifat HasanAssistant Professor, Department of Otolaryngology & Head Neck Surgery National Institute of ENT, Tejgaon, Dhaka, Bangladesh
• Md Rezaul KarimResearch Officer, Department of Otolaryngology & Head Neck Surgery National Institute of ENT, Tejgaon, Dhaka, Bangladesh
• Md Ashraful IslamAssistant Registrar, Department of Otolaryngology & Head Neck Surgery National Institute of ENT, Tejgaon, Dhaka, Bangladesh
• Muhammad Mozammal HaqueAssistant Professor, Department of ENT National Institute of ENT, Tejgaon, Dhaka, Bangladesh.

Keywords

Abstract

Background: Postoperative parathyroid dysfunction frequently occurs after thyroid surgery. Because of its brief half-life, early postoperative serum parathyroid hormone (PTH) serves as a dependable indicator of postoperative calcium imbalance and occurs prior to alterations in serum calcium. Nonetheless, information from Bangladesh is scarce. This research assessed alterations in serum PTH levels and the onset of postoperative biochemical and clinical signs following thyroid surgery. Methods: This prospective observational study, conducted prospectively, involved 120 patients who underwent thyroid surgery at Dhaka Medical College Hospital between January 2019 and June 2020. Serum PTH levels were measured preoperatively and 24 hours postoperatively, and patients were evaluated for postoperative hypoparathyroidism. Data analysis was performed using SPSS version 24.0, with p<0.05 regarded as statistically significant. Approval for ethical considerations and informed consent were secured. Results Of 120 patients, 17 (14.2%) experienced postoperative hypoparathyroidism, mainly in women, individuals aged 40–49 years, and those with papillary thyroid carcinoma. Mean serum PTH significantly declined following surgery (from 37.4 ± 10.9 to 22.8 ± 12.5 pg/ml, p < 0.001). Muscle cramps and paresthesia were the most frequently observed signs (41.2% each), with symptoms appearing within 24–48 hours after surgery. Conclusion: Thyroid surgery led to a notable decrease in postoperative serum PTH, with 14.2% of patients experiencing hypoparathyroidism. Measuring PTH levels soon after surgery, alongside careful biochemical and clinical observation, aids in the prompt identification and treatment of postoperative hypoparathyroidism, which may lessen complications and enhance patient results.

Journal of Paediatric Surgeons of Bangladesh (2026) Vol. 17 (2): 82–86