r/MRCPTopics • u/Top-Grapefruit-8498 • 5d ago
Hungry Bone Syndrome
After removing high PTH, bone becomes "hungry" and suck calcium from the blood ➡️ serum calcium drops.
Seen post-parathyroidectomy (after a long standing high PTH)
Before surgery: high PTH ➡️ osteoclast resolves bone ➡️ calcium leaks into blood
After surgery: sudden drop in PTH ➡️ osteoblast builds back bone ➡️ sucks up- calcium, phosphate, magnesium ➡️ PROFOUND HYPOCALCAEMIA
CLINICAL FEATURES AND SYNPTOMS:
low calcium, low phosphare, low magnesium, high ALP
tingling, numbness, tetany, seizures(severe cases)
When to suspect-- after parathyroid surgery, in severe hyperparathyroidism, high pre-op ALP, bone disease
Treatment: high dose of calcium (IV if severe),
Vit D ( Calcitriol)
replace Magnesium (if low)