"Hungry Bone" Syndrome after Parathyroidectomy: Up-To-Date

Abstract

The hungry bone syndrome is considered in literature as being a complication following parathyroidectomy and it refers to the rapidly installed, severe, prolonged, and in most cases clinically manifested hypocalcaemia, which is sometimes accompanied by hypophosphatemia and hypomagnesemia. It appears due to the rapid demineralization of the dystrophic bone as a result of the sudden drop in the seric level of the parathyroid hormone. The prevalence of this complication is reported in literature with different variations, the number reported ranging from 4-95% depending on the type of affection - i.e. primary hyperparathyroidism or renal secondary hyperparathyroidism, but also on the geographical areas where the respective reports have been filled. The high preoperatory level of calcaemia, seric parathyroid hormone and alkalyne phophatase correlate statistically with the risk of postoperatory hungry bone syndrome appearance; the elderly patients present a higher risk for this complication, increasingly because this category of patients is oftenly associated with D hypovitaminosis and insufficient intake of nutritional calcium. The syndrome semiology is one of a hypocalcaemia and the curative treatment is initially a symptomatic one of fighting the severe postparathyroidectomy hypocalcaemia and only later a patogenic one, aiming to remineralize the distrofic bone. The purpose of this review is to describe the main epidemiologic, physiopathologic and clinical aspects of hungry bone syndrome but also of presenting prevention and treatment methods for this complication of parathyroidectomy.