Hypoparathyroidism after thyroidectomy: A 20-year experience at a children’s hospital

Hypoparathyroidism (HP) is the most common complication of total thyroidectomy and can be an emergency. To describe the prevalence of HP after total thyroidectomy in children under 14 years of age, the variables related to its appearance and its clinical expression. Retrospective study at a children's hospital in the last 20 years. HP was defined by the need to supplement calcium after the intervention and was considered permanent if it could not be suspended within 12 months. Fisher’s statistical method of comparison of proportions. Thirty-nine children and adolescents (26 females) with an age range of 3.67–14.00 years. In 25 patients, the intervention was prophylactic and in 14 it was therapeutic; 14 suffered accidental excision of some parathyroid gland, but none more than two of them; 12 presented HP, of which 3 were permanent; 5 presented clinical symptoms; 1 of them was an emergency. The frequency of HP was 4/4 when 2 parathyroids were dissected, 2/10 when one was dissected, and 6/25 when none were dissected (p = 0.02). In the prophylactic interventions, it was 6/25 compared to 6/14 in the therapeutic ones (p = 0.29). The three cases of permanent HP were in children under 6 years of age, and it did not occur in any older children (p = 0.09). HP is a common and sometimes serious complication in children after total thyroidectomy. It can occur, and even be permanent, even if the intervention is prophylactic and parathyroid glands remain in situ. Younger age could be a risk factor. El hipoparatiroidismo (HP) es la complicación más frecuente de la tiroidectomía total y puede suponer una emergencia. Describir la prevalencia de HP tras tiroidectomía total en menores de 14 años, las variables relacionadas con su aparición y su expresión clínica. Estudio retrospectivo en un hospital infantil en los últimos 20 años. El HP se definió por la necesidad de suplementar calcio tras la intervención y se consideró permanente si no pudo suspenderse en 12 meses. Método estadístico de Fisher de comparación de proporciones. Treinta y nueve niños y adolescentes (26 mujeres) de un rango de edad de 3,67 a 14,00 años. En 25 pacientes la intervención fue profiláctica y en 14 terapéutica. Catorce sufrieron exéresis accidental de alguna glándula paratiroides, pero ninguno de más de dos de ellas. Doce presentaron HP, de los cuales 3 fueron permanentes, 5 presentaron sintomatología clínica y 1 de ellos supuso una emergencia. La frecuencia de HP fue de 4/4 cuando se disecaron 2 pa