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All Journal Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Syafril Syahbuddin
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Health Professions Medicine & Pharmacology Public Health

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Two-Year Follow-Up of Parathyroid Hormone, Calcium, and Vitamin D Serum Levels in a Patient after Parathyroidectomy Alexander Kam; Dinda Aprilia; Eva Decroli; Syafril Syahbuddin
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 2 No. 1 (2025): InaJEMD Vol. 2, No. 1
Publisher : PP PERKENI

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Parathyroidectomy is the definitive treatment for primary hyperparathyroidism. Because of the hungry bone syndrome and prolonged hypocalcemia risk, we must follow up on a patient's parathyroid hormone, calcium, and vitamin D serum after parathyroidectomy. In this case report, we reported on a parathyroidectomy patient whom we followed for two years and who, interestingly, had elevated parathyroid hormone levels. A 35-year-old male patient diagnosed with a left parathyroid tumor underwent parathyroidectomy and isthmolobectomy. The patient was treated with calcium, vitamin D, and levothyroxine supplementation. We diagnosed the patient with hungry bone syndrome on the fourth day of post-parathyroidectomy. Then, we documented calcium, vitamin D, and PTH levels in the next two years. The calcium levels are 7.2 (June 2022), 8.2 (July 2022), 8.5 (September 2022), 7.8 (October 2022), 8.1 (June 2023), 9.7 (June 2024). The PTH levels are 244.2 (June 2022), 328.3 (July 2022), 306.5 (September 2022), 457.2 (October 2022), 163.3 (June 2023), 34.4 (June 2024). The Vitamin D levels are 34.4 (July 2022), 13.4 (March 2023), 35.2 (September 2023), 50.4 (April 2024). We increased the dose of calcium and vitamin D supplementation. The patient is in good condition and has reached a normal level of these laboratory parameters in the second year post-parathyroidectomy. PTH, calcium, and vitamin D serum are needed for follow-up in patients after parathyroidectomy. Normalizing calcium and vitamin D serum is essential to maintaining a normal PTH level. Normal PTH, calcium, and vitamin D serum are the cure indications in this patient.
Pituitary Macroadenoma with Hypogonadism in 30 year old Liver Cirrhosis Patient: A Case Report Alexander Kam; Dinda Aprilia; Eva Decroli; Syafril Syahbuddin
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 2 No. 1 (2025): InaJEMD Vol. 2, No. 1
Publisher : PP PERKENI

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Abstract

Pituitary macroadenomas can suppress pituitary hormone secretion, one of which is the gonadotropin hormone, causing hypogonadism. The condition of hypogonadism can increase the risk of NAFLD, which can then become liver cirrhosis. A 30-year-old man came to the hospital with decreased consciousness and hematemesis melena. From physical examination, laboratory, and pituitary MRI, the patient was diagnosed with pituitary macroadenoma, hypogonadotropic hypogonadism, primary hypothyroidism, acute adrenal insufficiency, and liver cirrhosis. The patient was given hydrocortisone therapy, correction of electrolyte levels, hypoglycemia protocol, levothyroxine 100 mg/day, and management of hematemesis melena. After that, Sustanon 250 mg was given every two weeks intramuscularly. The patient went home in good condition and was planned for neurosurgery consultation for transsphenoidal resection. After the injection of Sustanon, the patient experienced increased penile length and testicular volume. The condition of hypogonadism in patients with pituitary macroadenoma can be a risk factor for NAFLD, which can then progress to liver cirrhosis. NAFLD and liver cirrhosis also can cause hypogonadism in men by several mechanisms. The patient has been well-managed and experienced clinical improvement.
Co-Authors Alexander Kam Dinda Aprilia Eva Decroli