Hungry bone syndrome. Report of four cases

Hungry bone syndrome is a unusual complication of the postoperative period of primary hyperparathyroidism. This syndrome is characterized by hypocalce mia, hypophosphatemia and hypomagnesemia, due to all excessive bone reminer alization. We report the clinical features, laboratory and therapy in four females (aged 39 to 73 years old) with a long standing hyperparathyroidism, elevated alkaline phosphatases and decreased bone mineralization in two. T he mean size of the adenoma was 2.9 +/- 1.1 cm. Hypocalcemia appeared betwe en days I and 6 of the postoperative period. All were ri eared with calcium , calcitriol and magnesium, at different timing and dosages, The mean hospi talization period was 19.8 +/- 2.1 days. As reported! previously low bone m ineralization and a large adenoma nle risk factors for the syndrome. Serial monitoring,tg of serum calcium and magnesium and an early supplementation of these minerals could prevent hypocalcemia and decrease the hospitalizati on time.