Role of Bisphosphonates in The Prevention of Postoperative Hungry Bone Syndrome in Primary Hyperparathyroidism: A Meta-Analysis and Need for Randomized Controlled Trials

Dear Editor,

Hungry bone syndrome (HBS) is a clinico-biochemical entity characterized by the development of profound and prolonged hypocalcemia associated with hypophosphatemia, hypomagnesemia, and rising alkaline phosphatase which follows curative parathyroidectomy for severe primary and secondary hyperparathyroidism. The prevalence of HBS after parathyroidectomy in primary hyperparathyroidism (PHPT) is variable with several case series from Asia reporting remarkably higher prevalence rates of 24–87% [1].

Publication History

Article published online:
09 December 2020

• References

• 1 Witteveen JE, van Thiel S, Romijn JA. et al. Therapy of endocrine disease: Hungry bone syndrome: Still a challenge in the post-operative management of primary hyperparathyroidism: A systematic review of the literature. Eur J Endocrinol 2013; 168: R45-R53
• 2 Kaderli RM, Riss P, Dunkler D. et al. The impact of vitamin D status on hungry bone syndrome after surgery for primary hyperparathyroidism. Eur J Endocrinol 2018; 178: 1-9
• 3 de França TCPT, Griz ET, de Andrade LD. et al. Bisfosfonatos podem minimizar a fome óssea após paratireoidectomia em pacientes com hiperparatireoidismo primário e osteíte fibrosa cística. Rev Bras Reumatol 2011; 51: 131-137
• 4 Slim K, Nini E, Forestier D. et al. Methodological index for non-randomized studies (MINORS): Development and validation of a new instrument. ANZ J Surg 2003; 73: 712-716
• 5 Lee I-T, Sheu WH-H, Tu S-T. et al. Bisphosphonate pretreatment attenuates hungry bone syndrome postoperatively in subjects with primary hyperparathyroidism. J Bone Miner Metab 2006; 24: 255-258
• 6 Mayilvaganan S, Vijaya Sarathi H, Shivaprasad C. Preoperative zoledronic acid therapy prevent hungry bone syndrome in patients with primary hyperparathyroidism. Indian J Endocrinol Metab 2017; 21: 76