Recovery of Parathyroid Hormone Secretion and Function in Postoperative Hypoparathyroidism: A Case Series

Context: Transient and permanent postoperative hypoparathyroidism are recognized complications of neck surgery. Postoperative hypoparathyroidism is usually considered permanent when it persists for 6 months; in rare cases, recovery of hypoparathyroidism through 1 year has been described. Recovery of hypoparathyroidism years after diagnosis has not previously been reported. Objective: We report four patients being treated with PTH(1–84) in a research protocol who recovered from postoperative hypoparathyroidism many years after onset. Methods: Recovery from hypoparathyroidism was established by: 1) serum calcium and PTH levels within the normal range off PTH(1–84) treatment for at least 1 week; 2) requirement for daily calcium supplementation reduced to ≤1 g; and 3) no supplemental active vitamin D therapy. Results: Hypoparathyroidism developed in three subjects after repeated neck surgery for primary hyperparathyroidism and in one subject after total thyroidectomy for Graves' disease. Parathyroid tissue au...