Multiple endocrine neoplasia syndromes

The risk of post-thyroidectomy hypoparathyroidism is higher in patients with MEN2. Parathyroid hormone deficiency can be treated with activated vitamin D (1-alpha calcidiol or calcitriol) to bring serum calcium into the low normal range while maintaining normal urine calcium levels.

Patients with MEN2B medullary thyroid cancer and phaeochromocytoma are at higher risk of early metastasis.[39]Vasen HF, van der Feltz M, Raue F, et al. The natural course of multiple endocrine neoplasia type IIb. A study of 18 cases. Arch Intern Med. 1992 Jun;152(6):1250-2. http://www.ncbi.nlm.nih.gov/pubmed/1350898?tool=bestpractice.com [40]Brauckhoff M, Gimm O, Brauckhoff K, et al. Repeat adrenocortical-sparing adrenalectomy for recurrent hereditary pheochromocytoma. Surg Today. 2004;34(3):251-5. http://www.ncbi.nlm.nih.gov/pubmed/14999539?tool=bestpractice.com

The risk of post-thyroidectomy hypoparathyroidism is lower with subtotal thyroidectomy and neck dissection.

Parathyroid hormone deficiency can be treated with activated vitamin D (1-alpha calcidiol or calcitriol) to bring serum calcium into the low normal range while maintaining normal urine calcium levels.

Persistent hypoparathyroidism and hypocalcaemia develops in 5% to 10% of patients with MEN1 undergoing parathyroidectomy (even by experienced surgeons) due to the need to visualise all existing parathyroid glands.

Treated with hormone replacement therapy.