{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:15:40Z","timestamp":1788380140526,"version":"build-2803163510"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Radioactive iodine therapy (RAIT) is a definitive treatment for hyperthyroidism, but parathyroid effects are often underrecognized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 66-year-old woman with a 30-year history of Graves\u2019 disease underwent RAIT (555\u00a0MBq 131I) after long-term treatment with thiamazole and briefly with propylthiouracil without achieving remission. Two weeks after RAIT, she developed paresthesia and muscle cramps, progressing to hospitalization one week later with positive Chvostek\u2019s and Trousseau\u2019s signs. Laboratory tests showed severe hypocalcemia (ionized calcium 0.70\u00a0mmol\/L), vitamin D deficiency, and low parathyroid hormone levels, consistent with parathyroid dysfunction (CTCAE Grade 3 hypocalcemia). She required intravenous and oral calcium plus vitamin D, with gradual improvement. At 9-month follow-up, calcium levels remained stable on supplementation, suggesting prolonged recovery of parathyroid function. She later developed post-RAIT hypothyroidism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the importance of considering transient parathyroid dysfunction in patients with symptomatic hypocalcemia after RAIT and supports long-term biochemical monitoring and supplementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/omcr\/omag161","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:52:13Z","timestamp":1787226733000},"source":"Crossref","is-referenced-by-count":0,"title":["Severe symptomatic hypocalcemia with probable transient parathyroid dysfunction following radioiodine therapy for Graves\u2019 disease: a case report"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7261-5915","authenticated-orcid":false,"given":"Anamarija","family":"Jankulovska","sequence":"first","affiliation":[{"name":"Institute of Pathophysiology and Nuclear Medicine \"Acad Isac S. Tadzer\", Faculty of Medicine, University of \u201cSs. Cyril and Methodius\u201d in Skopje , Str. Mother Teresa 17, 1000 Skopje ,","place":["Republic of North Macedonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Stojanoska","sequence":"additional","affiliation":[{"name":"Institute of Histology and Embryology, Faculty of Medicine, University of \u201cSs. Cyril and Methodius\u201d in Skopje , Str. Mother Teresa 17, 1000 Skopje ,","place":["Republic of North Macedonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Makazlieva","sequence":"additional","affiliation":[{"name":"Institute of Pathophysiology and Nuclear Medicine \"Acad Isac S. Tadzer\", Faculty of Medicine, University of \u201cSs. Cyril and Methodius\u201d in Skopje , Str. Mother Teresa 17, 1000 Skopje ,","place":["Republic of North Macedonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7168-3775","authenticated-orcid":false,"given":"Nevena","family":"Manevska","sequence":"additional","affiliation":[{"name":"Institute of Pathophysiology and Nuclear Medicine \"Acad Isac S. Tadzer\", Faculty of Medicine, University of \u201cSs. Cyril and Methodius\u201d in Skopje , Str. Mother Teresa 17, 1000 Skopje ,","place":["Republic of North Macedonia"]},{"name":"University Institute of Positron Emission Tomography , Bledski Dogovor 10, 1000 Skopje , Republic of","place":["North Macedonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinisha","family":"Stojanoski","sequence":"additional","affiliation":[{"name":"Institute of Pathophysiology and Nuclear Medicine \"Acad Isac S. Tadzer\", Faculty of Medicine, University of \u201cSs. Cyril and Methodius\u201d in Skopje , Str. Mother Teresa 17, 1000 Skopje ,","place":["Republic of North Macedonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"2026090215274626500_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2020.101387","article-title":"Graves' disease: epidemiology, genetic and environmental risk factors and viruses","volume":"34","author":"Antonelli","year":"2020","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"2026090215274626500_ref2","doi-asserted-by":"publisher","first-page":"3324","DOI":"10.1007\/s00259-023-06274-5","article-title":"The EANM guideline on radioiodine therapy of benign thyroid disease","volume":"50","author":"Campenn\u00ec","year":"2023","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2026090215274626500_ref3","doi-asserted-by":"publisher","first-page":"340","DOI":"10.5603\/EP.2013.0015","article-title":"Parathyroid gland function after radioiodine ((131)I) therapy for toxic and non-toxic goitre","volume":"64","author":"Szumowski","year":"2013","journal-title":"Endokrynol Pol"},{"key":"2026090215274626500_ref4","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1159\/000490384","article-title":"2018 European thyroid association guideline for the Management of Graves' hyperthyroidism","volume":"7","author":"Kahaly","year":"2018","journal-title":"Eur Thyroid J"},{"key":"2026090215274626500_ref5","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.eprac.2020.09.013","article-title":"Parathyroid hormone level changes following radioiodine therapy for thyroid cancer: a prospective observational study","volume":"27","author":"Wu","year":"2021","journal-title":"Endocr Pract"},{"key":"2026090215274626500_ref6","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.671787","article-title":"Parathyroid changes after RAI in patients with differentiated thyroid carcinoma","volume":"12","author":"Xiao","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2026090215274626500_ref7","doi-asserted-by":"publisher","first-page":"99","DOI":"10.3892\/br.2018.1110","article-title":"Changes in gene expression as one of the key mechanisms involved in radiation-induced bystander effect","volume":"9","author":"Sokolov","year":"2018","journal-title":"Biomed Rep"},{"key":"2026090215274626500_ref8","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1089\/thy.2011.0094","article-title":"Hypocalcemia following treatment with radioiodine in a child with graves' disease","volume":"22","author":"Komarovskiy","year":"2012","journal-title":"Thyroid"},{"key":"2026090215274626500_ref9","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1177\/039463201302600121","article-title":"Graves' disease, hypoparathyroidism, systemic lupus erythematosus, alopecia, and angioedema: autoimmune polyglandular syndrome variant or coincidence?","volume":"26","author":"Melcescu","year":"2013","journal-title":"Int J Immunopathol Pharmacol"},{"key":"2026090215274626500_ref10","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1007\/s12149-024-01996-4","article-title":"Long-term effect of postoperative radioactive iodine therapy on parathyroid function in patients with differentiated thyroid cancer","volume":"39","author":"Avc\u0131 Merdin","year":"2025","journal-title":"Ann Nucl Med"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/9\/omag161\/70925678\/omag161.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/9\/omag161\/70925678\/omag161.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T19:27:54Z","timestamp":1788377274000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omag161\/8780363"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":10,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omag161","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,9,1]]},"article-number":"omag161"}}