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Table 1 Cases of developing HBS after PTX

From: Multiple fractures due to hungry bone syndrome following parathyroidectomy: a clinical case report and review of literature

Author (Year)

Sex/Age

Presentation

Comorbidities

Diagnosis

Bone Radiography

Complication

Treatment of HBS

Varma et al. (2014) [24]

F/36

HyperCa & PTH crisis

N/A

P-HPT due to PC

Lytic lesions in the right femoral neck, right Sup. and Inf. pubic bones and left iliac wing

Osteitis fibrosa cystica

IV and oral Ca

Neagoe et al. (2014) [25]

M/57

Osteoarticular pains, muscular weakness, nausea & abdominal pains

Renal stones, Osteoporosis, HLP, IHD, Prostate adenoma

P-HPT due to PA

N/A

None

IV Ca-gluconate, Oral Alfacalcidol

F/60

Fatigue, muscular weakness, nausea, vomiting & dehydration

Hypothyroidism, Peptic disease

P-HPT due to PA

N/A

None

Oral Ca

Altun et al. (2015) [25]

F/20

HyperP, HypoCa & PTH crisis

ESRD on HD, Anuria

HPT-II without PA

N/A

Prolonged HypoP

IV Ca, Oral CaCO3 & calcitriol

F/32

HypoCa & PTH crisis

CTIN secondary to NBSD, HD, Anuria

M/35

PTH crisis

AA amyloidosis secondary to FMF, HD, Anuria

Ebina et al. (2015) [27]

M/16

Hip & right forearm pain

None

P-HPT due to PA

Lytic fractured lesion in both femoral neck and radial shaft

Multiple brown tumors & secondary osteoporosis

IV Ca & Mg, Oral Ca & calcitriol

Saif et al. (2015) [28]

F/15

Recurrent vomiting & abdominal pains

None

P-HPT due to PA

Osteopenia and lytic areas in the left iliac bone, the femoral neck bilaterally, and the right pubic bone

HyperCa-induced pancreatitis

IV & oral Ca, Oral Alfacalcidol

Rutledge et al. (2016) [29]

F/21

Enlarging right-sided neck mass

None

P-HPT due to APA

No osseous abnormalities

None

IV Ca, Oral Alfacalcidol, Oral P & Mg

Afshan et al. (2017) [30]

M/32

Perioral numbness, tingling, diffuse paresthesia & weakness

ESRD on PD, HTN, GERD

N/A

N/A

Severe & recurring HypoCa

Changing oral CaCO3 to Ca-citrate with oral clcitriol

Hendarto et al. (2017) [31]

F/18

Generalized bone pain

None

P-HPT due to PA

Severe scoliosis, multiple old fractures, bone erosions and resorption of the phalanges

None

Parenteral & oral Ca

Tai et al. (2018) [32]

F/56

Frequent urination, generalized weakness & pain

HTN, HLP, DM

P-HPT due to PA

Triangular fibrocartilage complex chondrocalcinosis

Pseudogout

IV Ca & Mg, Colchicine, Naproxen

Florakis et al. (2019) [33]

M/44

Chronic arthralgia & myalgia

None

P-HPT due to APA

Diffuse osteopenia of hip-pelvis and lumbar spine

HPT-II due to vit D deficiency

Alfacalcidol, Ca, vit D and Mg

Tai et al. (2019) [34]

M/74

HyperP, HyperCa & PTH crisis

ESRD on HD, HTN

HPT-III due to PG & ectopic PG

N/A

None

IV Ca-chloride, Oral Ca-acetate and vit D

Ahmed et al. (2020) [35]

F/35

HypoCa & PTH crisis

SLE, on HD

HPT-II

N/A

None

IV Ca & vit D, Oral Ca & teriparatide

Buisset et al. (2020) [36]

F/20

HyperCa & PTH crisis

None

P-HPT due to PC

Diffuse bone demineralization

Osteitis fibrosa cystica & multiple brown tumors

Oral Ca & vit D

Lenherr-Taube et al. (2020) [37]

F/13

HyperCa & PTH crisis

Bilateral genu varum, Hip impingement

P-HPT due to PA

Lytic lesions throughout the skeleton and widening of the bilateral sacroiliac joints

None

IV Ca, Oral CaCO3 & calcitriol

Raj et al. (2020) [38]

F/66

HypoCa & PTH crisis & fatigue

Renal stones

P-HPT due to PA

N/A

HPT-II due to CKD

IV Ca-gluconate, Oral Ca, calcitriol & Ergocalciferol

Alvarez et al. (2022) [39]

F/55

Mechanical pain in the right shoulder & loss of strength

Osteoarthritis, HTN

P-HPT due to PA

Lytic lesions on the proximal humerus, sternum, acromion, sixth anterior left costal arch, iliac bones, left femoral head, and fracture of the Sup. vertebral disc

Acute and chronic pulmonary embolisms

IV Ca-gluconate, Oral calcitriol & Ca

Landeta et al. (2022) [40]

M/56

HyperP, HypoCa & PTH crisis

HTN, BPH

P-HPT due to PA

N/A

None

IV Ca-gluconate, Oral CaCO3

Vitale et al. (2022) [41]

M/12

Nausea, HyperCa & PTH crisis

Obesity, Autism spectrum disorder

P-HPT due to PA

N/A

None

Oral Ca & calcitriol

Zelano et al. (2022) [42]

M/56

HypoCa, fatigue, abdominal pain, vomiting, dehydration & weight loss

None

P-HPT due to PC

Calcification in the cartilage around the joints, associated with synovitis in hands, wrists, elbows, knees, and ankles

Articular pain & pancreatic exocrine insufficiency

IV Ca, Oral calcitriol

Martínez‑Loya et al. (2023) [43]

M/34

Muscle weakness

Bilateral hip fractures

P-HPT due to PA

N/A

None

IV Ca, Oral calcitriol & CaCO3

Nievera et al. (2023) [44]

M/21

Severe pain of both thighs & his legs give way

None

P-HPT due to PA

Displaced fractures of both upper femoral shafts

None

IV Ca-gluconate, Oral Ca

Shah et al. (2023) [45]

M/64

Inability to walk for nine days & bilateral knee pain radiating to shins

HTN, DM

P-HPT due to PA

N/A

None

Oral calcitriol & CaCO3

Liu et al. (2024) [46]

M/57

Multiple pathological fractures, muscle atrophy & bone pain

None

P-HPT due to PC

Femoral neck fracture and muscle atrophy around the left hip, bilateral humeral shaft fractures

Numbness in perioral sites and fingertips

IV Ca-gluconate, Oral Vit D

Papanikos et al. (2024) [47]

M/67

HyperCa, nausea, drowsiness, & weakness

HTN, HLP, Hyperuricemia

P-HPT due to PA

N/A

None

IV Ca-gluconate, Oral Alfacalcidol

  1. HBS, Hungry bone syndrome; PTX, Parathyroidectomy; HyperCa, Hypercalcemia; PTH, Parathyroid hormone; P-HPT, Primary hyperparathyroidism; PC, Parathyroid carcinoma; Sup, Superior; Inf, Inferior; IV, Intravenous; Ca, Calcium; HLP, Hyperlipidemia; IHD, Ischemic heart disease; PA, Parathyroid adenoma; HyperP, Hyperphosphatemia; HypoCa, Hypocalcemia; HPT-II, secondary hyperparathyroidism; ESRD, End stage renal disease; HD, Hemodialysis; CTIN, Chronic tubulointerstitial nephritis; NBSD, Neurogenic bladder sphincter dysfunction; AA, Amyloid A; FMF, Familial Mediterranean fever; HypoP, Hypophosphatemia; CaCO3, Calcium carbonate; Mg, Magnesium; APA, Atypical parathyroid adenoma; P, Phosphorus; PD, Peritoneal dialysis; HTN, Hypertension; GERD, Gastroesophageal reflux disease; SLE, Systemic lupus erythematosus; DM, Diabetes mellitus; PG, Parathyroid gland; CKD, Chronic kidney disease; BPH, Benign prostate hyperplasia.