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      Parathyroid Changes After RAI in Patients With Differentiated Thyroid Carcinoma

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          Abstract

          Objective

          The purpose of this study was to investigate parathyroid hormone (PTH), serum calcium, phosphorus, and 25-hydroxyvitamin D (25-OH-VD) changes before and after radioactive iodine (RAI) in differentiated thyroid carcinoma (DTC) patients at different time points.

          Methods

          A total of 259 DTC patients who received RAI were prospectively enrolled. We evaluated PTH, serum calcium, phosphorus, and 25-OH-VD levels at baseline pre-RAI, five days, six weeks, and six months post-RAI, respectively. We analyzed the risk factors of hypocalcemia at five days post-RAI.

          Results

          The mean PTH, serum calcium and phosphorus values decreased five days post-RAI compared with pre-RAI (PTH 4.18 ± 1.23 pmol/L vs. 3.95 ± 1.41 pmol/L; calcium 2.27 ± 0.09 mmol/L vs. 2.20 ± 0.11 mmol/L; phosphorus 1.25 ± 0.17 vs. 0.98 ± 0.20 mmol/L, P < 0.05), and the differences were statistically significant. The mean 25-OH-VD levels did not significantly decrease at five days post-RAI. 21.2% (55/259) of patients had hypocalcemia at five days post-RAI, and all of them were given oral calcium supplements. At six weeks post-RAI, all of the above parameters were higher than those at five days post-RAI. Multivariate regression analysis showed that baseline pre-RAI serum calcium < 2.27 mmol/L, PTH < 4.18 pmol/L and negative 99mTcO 4 - thyroid imaging were risk factors for hypocalcemia at five days post-RAI.

          Conclusion

          For DTC patients with normal PTH and serum calcium levels at pre-RAI, their PTH, serum calcium, and phosphorus levels decreased at five days post-RAI. About one-fifth of patients could have hypocalcemia at five days post-RAI. Lower baseline pre-RAI serum calcium and PTH levels and negative 99mTcO 4 - thyroid imaging were risk factors for hypocalcemia five days post-RAI.

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          Most cited references16

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          2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.

          Bryan Haugen, Erik Alexander, Keith Bible … (2016)
          Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer.
          Article 0 comments Cited 2575 times – based on 0 reviews     Review now
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            Huge variations in definition and reported incidence of postsurgical hypoparathyroidism: a systematic review

            Torben Harsløf, Lars Rolighed, Lars Rejnmark (2019)
            Article 0 comments Cited 21 times – based on 0 reviews     Review now
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              Parathyroid changes after high dose radioactive iodine in patients with thyroid cancer.

              Aytekin Güven, Serpil Salman, Harika Boztepe … (2009)
              The study aimed to investigate the effect of high dose radioactive iodine (RAI) on parathyroid function in patients with differentiated thyroid cancer.
              Article 0 comments Cited 7 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Endocrinol (Lausanne)
                Journal ID (iso-abbrev): Front Endocrinol (Lausanne)
                Journal ID (publisher-id): Front. Endocrinol.
                Title: Frontiers in Endocrinology
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-2392
                Publication date (Electronic): 27 May 2021
                Publication date Collection: 2021
                Volume: 12
                Electronic Location Identifier: 671787
                Affiliations
                [1] Department of Nuclear Medicine, West China Hospital of Sichuan University , Chengdu, China
                Author notes

                Edited by: Leonidas H. Duntas, National University Of Athens, Greece

                Reviewed by: Haixia Guan, Guangdong Provincial People’s Hospital, China; Jonathon Russell, Johns Hopkins Medicine, United States

                This article was submitted to Thyroid Endocrinology, a section of the journal Frontiers in Endocrinology

                †These authors have contributed equally to this work

                Article
                DOI: 10.3389/fendo.2021.671787
                PMC ID: 8190475
                PubMed ID: 34122347
                SO-VID: 6e1d530f-22c4-45de-9884-6e7ff5f4d5bc
                Copyright © Copyright © 2021 Xiao, Zhang, Zhu, Wang, Liu, Huang and Li
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 24 February 2021
                Date accepted : 12 May 2021
                Page count
                Figures: 2, Tables: 5, Equations: 0, References: 16, Pages: 8, Words: 4338
                Categories
                Subject: Endocrinology
                Subject: Original Research

                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: differentiated thyroid carcinoma,parathyroid hormone,serum calcium,serum phosphorus,radioactive iodine
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: differentiated thyroid carcinoma, parathyroid hormone, serum calcium, serum phosphorus, radioactive iodine

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