RESUMEN
Hungry bone syndrome is a common clinical entity which is accompanying of hypocalcemia, hypomagnesemia, and hipophosphatemia, results from an increase in bone formation. It is related to a pathological scenario which causes an imbalance between osteoclast-mediated bone resorption and osteoblast-mediates bone formation, favouring the latter. Its classic presentation occurs after parathyroidectomy in hyperparathyroydism's patients. Its clinical features are largely due to plasmatic calcium levels reduction. Hungry bone syndrome is frequent in hyperparathyroid's patients who have development bone disease before surgery. Even less frequent, it has also been described after thyroydectomy in patients with hyperthyroidism. We hereby report a case of hungry bone syndrome in one patient who suffers a Graves' disease. Then, we will provide a brief review of pathogenesis and therapeutic features.
Asunto(s)
Hipertiroidismo/complicaciones , Hipocalcemia/etiología , Hipoparatiroidismo/etiología , Tiroidectomía/efectos adversos , Adulto , Análisis Químico de la Sangre , Conservadores de la Densidad Ósea/uso terapéutico , Calcitriol/uso terapéutico , Gluconato de Calcio/uso terapéutico , Femenino , Humanos , Hipertiroidismo/diagnóstico , Hipertiroidismo/cirugía , Hipocalcemia/sangre , Hipocalcemia/tratamiento farmacológico , Hipoparatiroidismo/sangre , Hipoparatiroidismo/tratamiento farmacológico , Deficiencia de Magnesio/sangre , Deficiencia de Magnesio/tratamiento farmacológico , Deficiencia de Magnesio/etiología , Complicaciones Posoperatorias , Resultado del TratamientoRESUMEN
El síndrome del hueso hambriento es una entidad clínica que se caracteriza por la aparición de hipocalcemia, hipofosfatemia e hipomagnesemia secundaria a un aumento de su captación a nivel óseo. Es un proceso que se ha descrito en el contexto de enfermedades que actúan generando un disbalance entre la producción y la resorción, a favor de ésta última. La forma clásica de presentación, acontece tras la realización de una paratiroidectomia en pacientes con hiperparatiroidismo (HPT), siendo su clínica la relacionada fundamentalmente con la caída de los niveles plasmáticos de calcio. Aunque menos habitual, ha sido descrito tras tratamiento quirúrgico de entidades clínicas que cursan con un exceso de hormonas tiroideas, siendo la forma más frecuente la enfermedad de Graves-Basedow. Presentamos un caso de este síndrome tras tiroidectomía en un paciente con hipertiroidismo primario por enfermedad de Graves, realizando una breve revisión de los aspectos fisiopatológicos y manejo del cuadro
Hungry bone syndrome is a common clinical entity which is accompanying of hypocalcemia, hypomagnesemia, and hipophosphatemia, results from an increase in bone formation. It is related to a pathological scenario which causes an imbalance between osteoclast-mediated bone resorption and osteoblast-mediates bone formation, favouring the latter. Its classic presentation occurs after parathyroidectomy in hyperparathyroydism´s patients. Its clinical features are largely due to plasmatic calcium levels reduction. Hungry bone syndrome is frequent in hyperparathyroid´s patients who have development bone disease before surgery. Even less frequent, it has also been described after thyroydectomy in patients with hyperthyroidism. We hereby report a case of hungry bone syndrome in one patient who suffers a Graves´ disease. Then, we will provide a brief review of pathogenesis and therapeutic features