Transient teriparatide for postoperative hypocalcaemia with hungry bone features
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ID: 324915
2026
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Abstract
Abstract Postoperative hypocalcaemia after parathyroidectomy may be challenging to manage. We report a 50-year-old man with severe primary hyperparathyroidism, very high parathyroid hormone levels, markedly elevated alkaline phosphatase and extensive skeletal disease, including a brown tumour with pathological fracture. Following parathyroidectomy, he developed persistent postoperative hypocalcaemia with biochemical features suggestive of both transient postoperative hypoparathyroidism and hungry bone physiology. Despite high-dose calcium, calcitriol and electrolyte replacement, hypocalcaemia persisted, requiring ICU admission and prolonged intravenous supplementation. Teriparatide was initiated on postoperative day 11 at a dose of 20 µg twice daily, subsequently reduced to 20 µg once daily. Thereafter, calcium levels progressively normalised, allowing discontinuation of intravenous supplementation and early hospital discharge. A short course was associated with sustained calcium–phosphate stabilisation without recurrence of hypocalcaemia during follow-up. This case highlights the potential role of short-term teriparatide as rescue therapy in selected patients with persistent postoperative hypocalcaemia and hungry bone features.
| Reference Key |
openalex_W7202359213
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| Authors | I Borrego-Soriano, P Parra Ramírez, P Martín Rojas-Marcos, J Gómez-Ramírez, R Arranz-Jiménez, I Huget-Moreno, T Rojas-Lopez, P Vázquez-Pérez, C Álvarez-Escolá |
| Journal | european journal of endocrinology |
| Year | 2026 |
| DOI |
10.1093/ejendo/lvag150
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| URL | |
| Keywords | Keywords not found |
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