A 19-year-old man with MEN1 syndrome undergoes parathyroidectomy with cryopreservation for recurrent primary hyperparathyroidism. Postoperatively, he presents with tetany, paresthesias, and positive Chvostek sign. Vital signs show HR 102, RR 18, BP 128/76. Laboratory studies reveal ionized calcium 3.2 mg/dL (normal 4.5-5.3), phosphate 5.2 mg/dL, magnesium 1.8 mg/dL, and PTH <5 pg/mL. Urinary calcium is normal. Which mechanism best explains his acute hypocalcemia?
- A)Hypomagnesemia from operative blood loss
- B)Thyroid hormone suppression of calcium reabsorption
- C)Tertiary hyperparathyroidism reversal
- D)Inadequate cryopreservation of parathyroid tissue
- E)Hungry bone syndrome with rapid mineral uptake by previously hyperstimulated osteoblastsGABARITO
Explicação
Hungry bone syndrome occurs immediately after parathyroidectomy in patients with severe hyperparathyroidism. The skeleton, previously stimulated by excessive PTH, rapidly remineralizes once PTH is removed, causing acute hypocalcemia. This is a transient condit... Ver explicação completa e trilha adaptativa →