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Obesity Surgery

, Volume 19, Issue 4, pp 524–526 | Cite as

Refractory Hypocalcemia Following Near-Total Thyroidectomy in a Patient with a Prior Roux-en-Y Gastric Bypass

  • Sara M. Pietras
  • Michael F. Holick
Case Report

Abstract

Patients undergoing malabsorptive weight-loss procedures are at increased risk of calcium and vitamin D deficiency. Thyroidectomy carries the risk of both immediate and long-term hypocalcemia. Here we describe a patient who underwent Roux-en-Y gastric bypass (RYGB) and subsequent near-total thyroidectomy and then developed refractory hypocalcemia. Serum calcium reached a nadir of 6.1 mg/dl despite aggressive therapy with oral and IV calcium, calcitriol (1,25(OH)2D3), and IV magnesium sulfate. One year later, the patient has permanent hypoparathyroidism and requires very high doses of calcium, vitamin D, and calcitriol to prevent symptomatic hypocalcemia. Providers should be aware that malabsorption of calcium and vitamin D after RYGB may complicate patient management after thyroidectomy.

Keywords

Hypocalcemia Roux-en-Y gastric bypass Thyroidectomy Hypoparathyroidism Weight-loss surgery 

Notes

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Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  1. 1.Section of Endocrinology, Diabetes and NutritionBoston University School of Medicine, Boston Medical CenterBostonUSA

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