Abstract

HUNGRY BONE SYNDROME (HBS)- A CASE REPORT

Dr. Shajeer Ali C. P.*, Dr. Mahesh D. M., Dr. Praveen Kumar, Midhun J. Madhu, Navya Sara Santhosh

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Abstract

Hungry bone syndrome is a rare but severe condition where the patients calcium levels drops persistently for a long time period after parathyroidectomy. Along with hypocalcaemia patient may also experience hypophosphatemia and hypomagnesaemia. It is a relatively uncommon but serious adverse effect of parathyroidectomy. Parathyroid Hormone (PTH) produced by parathyroid gland helps to regulate and maintain the calcium levels in the body. There are four parathyroid gland and hyperactivity of these glands (Hyperparathyroidism) leads to increase in the PTH levels which further increase the serum calcium by forcing bones to release high amount of calcium in to the blood stream. ALP (Alkaline phosphatase) values will also be high in such cases. In patients with severe hyperparathyroidism post-operative period after the removal of one or more hyper active parathyroid glands the PTH levels in the body drops drastically which results in the drop in calcium levels which usually settles within four days. In patients with HBS the calcium levels along with phosphorus and magnesium drops even after the fourth day of surgery. The severe hypocalcaemia is mainly due to increased calcium influx into the bones. Patients with HBS will also have sever VIT d deficiency. HBS is characterised by long standing hypocalcaemia along with symptoms like Chvostek sign and Trousseau sign, perioral paraesthesia, carpopedal spasms, tingling extremities.

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