hungry bones syndromeJoe Segen2016-11-26T03:03:22+00:00
hungry bones syndrome
Definition A popular term for transient hypoparathyroidism which follows surgical excision of major chunks of the parathyroid gland that were in secretory overdrive and secreting excess PTH–due to hyperplasia or an adenoma, which caused high alkaline phosphatase and significant bone demineralisation. The hungry bit comes from the rapid rebound recalcification of bones after prolonged hypocalcemia; bone hunger is exacerbated by pre-existing renal dysfunction
Imaging Mottled bone hypodensity
Lab Increased calcitriol, markedly decreased Ca2+–e.g., 1.5 mmol/L–US: 6 mg/dl or lower, decreased phosphorus, decreased magnesium, reactive increase in PTH–if there is residual secretion; the danger lies in attributing symptoms to acidosis, which may accompany and exacerbate the syndrome.
Management Vitamin 1,25(OH)D2
Synonym Post-parathyroid surgery recalcification tetany