Recalcitrant Hypocalcemia: Postsurgical Hypoparathyroidism Exacerbated by a Chyle Leak Treated With Octreotide
Background/ObjectiveTo report a case of recalcitrant post-surgical hypocalcemia caused by hypoparathyroidism complicated by a chyle leak and octreotide use.Case ReportA man in his 60s with a 4-month history of voice changes, 10-pound weight loss, and a right-sided neck mass presented with difficulty...
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| Veröffentlicht in: | AACE clinical case reports 2024, Vol.10 (2), p.67-70 |
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| creator | Dorcely, Brenda Ibrahim, Nouran Natter, Michael Ziluck, Noah Greene, Loren Wissner |
| description | Background/ObjectiveTo report a case of recalcitrant post-surgical hypocalcemia caused by hypoparathyroidism complicated by a chyle leak and octreotide use.Case ReportA man in his 60s with a 4-month history of voice changes, 10-pound weight loss, and a right-sided neck mass presented with difficulty breathing for 1 week. He had a right laryngeal/hypopharyngeal mass, which was biopsied. Pathology results were positive for invasive squamous cell carcinoma. He underwent an extensive neck surgery, including total thyroidectomy. Postsurgical laboratory results revealed serum corrected calcium of 7.6 mg/dL (ref 8.0-10.2 mg/dL) and parathyroid hormone |
| doi_str_mv | 10.1016/j.aace.2024.01.003 |
| format | Report |
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He had a right laryngeal/hypopharyngeal mass, which was biopsied. Pathology results were positive for invasive squamous cell carcinoma. He underwent an extensive neck surgery, including total thyroidectomy. Postsurgical laboratory results revealed serum corrected calcium of 7.6 mg/dL (ref 8.0-10.2 mg/dL) and parathyroid hormone <6.3 pg/mL (ref. 10-65). Despite treatment with calcium carbonate 12 g (elemental) daily, calcitriol and hydrochlorothiazide, his corrected serum calcium levels remained low. Patient also had a chyle leak that was treated with octreotide. Resolution of his hypocalcemia occurred after substitution of calcium carbonate with calcium citrate, cessation of octreotide, and management of the chyle leak.DiscussionOur patient likely developed recalcitrant hypocalcemia from: 1) postsurgical hypoparathyroidism, 2) a chyle leak, and 3) the use of octreotide. Administration of octreotide to seal the chyle leak most likely decreased gastric acid production and contributed to decrease in absorption of calcium carbonate. Oral calcium citrate may be better absorbed in this case.ConclusionPostsurgical hypoparathyroidism can lead to hypocalcemia. This case is unique in that the patient's chyle leak and the use of octreotide contributed to recalcitrant hypocalcemia.</description><identifier>EISSN: 2376-0605</identifier><identifier>DOI: 10.1016/j.aace.2024.01.003</identifier><language>eng</language><ispartof>AACE clinical case reports, 2024, Vol.10 (2), p.67-70</ispartof><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>780,784,864,4490,27925</link.rule.ids></links><search><creatorcontrib>Dorcely, Brenda</creatorcontrib><creatorcontrib>Ibrahim, Nouran</creatorcontrib><creatorcontrib>Natter, Michael</creatorcontrib><creatorcontrib>Ziluck, Noah</creatorcontrib><creatorcontrib>Greene, Loren Wissner</creatorcontrib><title>Recalcitrant Hypocalcemia: Postsurgical Hypoparathyroidism Exacerbated by a Chyle Leak Treated With Octreotide</title><title>AACE clinical case reports</title><description>Background/ObjectiveTo report a case of recalcitrant post-surgical hypocalcemia caused by hypoparathyroidism complicated by a chyle leak and octreotide use.Case ReportA man in his 60s with a 4-month history of voice changes, 10-pound weight loss, and a right-sided neck mass presented with difficulty breathing for 1 week. He had a right laryngeal/hypopharyngeal mass, which was biopsied. Pathology results were positive for invasive squamous cell carcinoma. He underwent an extensive neck surgery, including total thyroidectomy. Postsurgical laboratory results revealed serum corrected calcium of 7.6 mg/dL (ref 8.0-10.2 mg/dL) and parathyroid hormone <6.3 pg/mL (ref. 10-65). Despite treatment with calcium carbonate 12 g (elemental) daily, calcitriol and hydrochlorothiazide, his corrected serum calcium levels remained low. Patient also had a chyle leak that was treated with octreotide. Resolution of his hypocalcemia occurred after substitution of calcium carbonate with calcium citrate, cessation of octreotide, and management of the chyle leak.DiscussionOur patient likely developed recalcitrant hypocalcemia from: 1) postsurgical hypoparathyroidism, 2) a chyle leak, and 3) the use of octreotide. Administration of octreotide to seal the chyle leak most likely decreased gastric acid production and contributed to decrease in absorption of calcium carbonate. Oral calcium citrate may be better absorbed in this case.ConclusionPostsurgical hypoparathyroidism can lead to hypocalcemia. This case is unique in that the patient's chyle leak and the use of octreotide contributed to recalcitrant hypocalcemia.</description><issn>2376-0605</issn><fulltext>true</fulltext><rsrctype>report</rsrctype><creationdate>2024</creationdate><recordtype>report</recordtype><recordid>eNqVjcFKw0AURYeCYNH-QFez7Kbjm0ybpG5LpQtBkUKX5XXyNFMnmTjzAubvjcUfcHW55x64Qsw1KA06f7goREsqg2ylQCsAMxHTzBT5EnJY34pZSheA0TSFNvlUtG9k0VvHEVuW-6ELv5Uah4_yNSROffxwI7pOHUbkeojBVS41cvc9XsUzMlXyPEiU23rwJJ8JP-Uh0pUfHdfyxXKkwK6ie3Hzjj7R7C_vxOJpd9jul10MXz0lPjUuWfIeWwp9OmWbcl1sViWU5h_qD-OPVNw</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Dorcely, Brenda</creator><creator>Ibrahim, Nouran</creator><creator>Natter, Michael</creator><creator>Ziluck, Noah</creator><creator>Greene, Loren Wissner</creator><scope>7X8</scope></search><sort><creationdate>20240301</creationdate><title>Recalcitrant Hypocalcemia: Postsurgical Hypoparathyroidism Exacerbated by a Chyle Leak Treated With Octreotide</title><author>Dorcely, Brenda ; Ibrahim, Nouran ; Natter, Michael ; Ziluck, Noah ; Greene, Loren Wissner</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-proquest_miscellaneous_29857948083</frbrgroupid><rsrctype>reports</rsrctype><prefilter>reports</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>online_resources</toplevel><creatorcontrib>Dorcely, Brenda</creatorcontrib><creatorcontrib>Ibrahim, Nouran</creatorcontrib><creatorcontrib>Natter, Michael</creatorcontrib><creatorcontrib>Ziluck, Noah</creatorcontrib><creatorcontrib>Greene, Loren Wissner</creatorcontrib><collection>MEDLINE - Academic</collection></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dorcely, Brenda</au><au>Ibrahim, Nouran</au><au>Natter, Michael</au><au>Ziluck, Noah</au><au>Greene, Loren Wissner</au><format>book</format><genre>unknown</genre><ristype>RPRT</ristype><atitle>Recalcitrant Hypocalcemia: Postsurgical Hypoparathyroidism Exacerbated by a Chyle Leak Treated With Octreotide</atitle><jtitle>AACE clinical case reports</jtitle><date>2024-03-01</date><risdate>2024</risdate><volume>10</volume><issue>2</issue><spage>67</spage><epage>70</epage><pages>67-70</pages><eissn>2376-0605</eissn><abstract>Background/ObjectiveTo report a case of recalcitrant post-surgical hypocalcemia caused by hypoparathyroidism complicated by a chyle leak and octreotide use.Case ReportA man in his 60s with a 4-month history of voice changes, 10-pound weight loss, and a right-sided neck mass presented with difficulty breathing for 1 week. He had a right laryngeal/hypopharyngeal mass, which was biopsied. Pathology results were positive for invasive squamous cell carcinoma. He underwent an extensive neck surgery, including total thyroidectomy. Postsurgical laboratory results revealed serum corrected calcium of 7.6 mg/dL (ref 8.0-10.2 mg/dL) and parathyroid hormone <6.3 pg/mL (ref. 10-65). Despite treatment with calcium carbonate 12 g (elemental) daily, calcitriol and hydrochlorothiazide, his corrected serum calcium levels remained low. Patient also had a chyle leak that was treated with octreotide. Resolution of his hypocalcemia occurred after substitution of calcium carbonate with calcium citrate, cessation of octreotide, and management of the chyle leak.DiscussionOur patient likely developed recalcitrant hypocalcemia from: 1) postsurgical hypoparathyroidism, 2) a chyle leak, and 3) the use of octreotide. Administration of octreotide to seal the chyle leak most likely decreased gastric acid production and contributed to decrease in absorption of calcium carbonate. Oral calcium citrate may be better absorbed in this case.ConclusionPostsurgical hypoparathyroidism can lead to hypocalcemia. This case is unique in that the patient's chyle leak and the use of octreotide contributed to recalcitrant hypocalcemia.</abstract><doi>10.1016/j.aace.2024.01.003</doi></addata></record> |
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| ispartof | AACE clinical case reports, 2024, Vol.10 (2), p.67-70 |
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| language | eng |
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| source | DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| title | Recalcitrant Hypocalcemia: Postsurgical Hypoparathyroidism Exacerbated by a Chyle Leak Treated With Octreotide |
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