Secondary hyperparathyroidism (SHPT) is a common complication of end-stage renal disease (ESRD), and part of SHPT patients need receive parathyroidectomy (PTX). However, as an important postoperative complication of SHPT, thyrotoxicosis has received little attention. Therefore, in this article, we aimed to study the status of transient thyrotoxicosis after PTX for SHPT patients with ESRD and normal thyroid function. A total of 24 SHPT patients with preoperative normal thyroid function, normal thyroglobulin (Tg) and normal thyroid antibodies receiving PTX were enrolled from the Department of Endocrine and Breast Surgery, the First Affiliated Hospital of Chongqing Medical University, from January 2017 to January 2019. Tg, high sensitivity thyrotropin stimulating hormone (sTSH), triiodothyronine (T3), free triiodothyronine (fT3), thyroxine (T4) and free thyroxine (fT4) were evaluated the day before PTX and on day 1, 3 and 5 after PTX. Besides, all enrolled patients were evaluated whether there are symptoms associated with thyrotoxicosis. Among the 24 SHPT patients, 1 case (4.2%), 8 cases (33.3%) and 13 cases (54.2%) had suffered thyrotoxicosis at the first, third and fifth day after surgery, respectively. Serum FT4 level increased significantly from pre-operation (0.68 ± 0.15 ng/dl, normal range 0.59–1.25 ng/dl) to the third day after operation (1.91 ± 0.97 ng/dl, p<0.001) and then gradually decline. The frequencies of serum sTSH lower than the normal level gradually increased from the first day (8.3%) to fifth day (66.7%) after surgery. Transient thyrotoxicosis is a common postoperative complication of parathyroidectomy for SHPT patients with ESRD and normal thyroid function, and it is necessary for clinicians to evaluate the perioperative thyroid function to make early diagnosis and appropriate prevention and treatment of thyrotoxicosis.

中文翻译：

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继发性甲状旁腺功能亢进症伴终末期肾脏病和甲状腺功能正常的继发性甲状腺毒症的临床研究

继发性甲状旁腺功能亢进症（SHPT）是终末期肾脏疾病（ESRD）的常见并发症，部分SHPT患者需要接受甲状旁腺切除术（PTX）。然而，作为SHPT的重要术后并发症，甲状腺毒症很少受到关注。因此，在本文中，我们旨在研究PTX后ESRD和甲状腺功能正常的SHPT患者短暂性甲状腺毒症的状况。2017年1月至2019年1月，重庆医科大学附属第一医院内分泌与乳腺外科共收治了24例术前甲状腺功能正常，甲状腺球蛋白（Tg）正常，甲状腺抗体正常的SHPT患者。 Tg，高敏感性促甲状腺激素刺激激素（sTSH），三碘甲状腺素（T3），游离三碘甲状腺素（fT3），在PTX前一天以及PTX后第1、3和5天评估甲状腺素（T4）和游离甲状腺素（fT4）。此外，所有入组患者均接受了甲状腺毒症相关症状的评估。在24例SHPT患者中，分别在术后第一天，第三天和第五天发生甲中毒1例（4.2％），8例（33.3％）和13例（54.2％）。血清FT4水平从术前（0.68±0.15 ng / dl，正常范围0.59–1.25 ng / dl）至术后第三天（1.91±0.97 ng / dl，p <0.001）显着升高，然后逐渐下降。血清sTSH低于正常水平的频率从术后第一天（8.3％）逐渐增加到第五天（66.7％）。