{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T14:25:52Z","timestamp":1784903152905,"version":"3.55.0"},"reference-count":9,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,9,22]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>A 39-year-old man was admitted to our hospital with the diagnosis of thyroid storm due to Graves\u2019 disease. Near-total thyroidectomy was performed after 1\u2009month\u2019s pharmacological treatment, and he presented with tetany next morning. Serum corrected calcium value was 5.7\u2009mg\/dL. Procollagen type 1 N-terminal propeptide increased considerably, while tartrate-resistant acid phosphatase 5b decreased. These changes indicated that bone formation exceeded bone resorption in reverse after thyroidectomy. Calcium gluconate was administered intravenously for 14 days, before the patient was discharged. Oral administration of calcium and active forms of vitamin D was continued for 4 months. Rapid skeletal uptake of calcium from blood caused severe and persistent hypocalcaemia, which is called hungry bone syndrome. When patients with Graves\u2019 disease have severe thyrotoxicosis, high serum alkaline phosphatase levels and low bone mineral densities, they are at high risk for hungry bone syndrome after thyroidectomy, and should be educated for the symptoms of hypocalcaemia.<\/jats:p>","DOI":"10.1136\/bcr-2019-231411","type":"journal-article","created":{"date-parts":[[2019,10,11]],"date-time":"2019-10-11T08:05:15Z","timestamp":1570781115000},"page":"e231411","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Hungry bone syndrome after thyroidectomy for thyroid storm"],"prefix":"10.1136","volume":"12","author":[{"given":"Kazuhisa","family":"Kusuki","sequence":"first","affiliation":[{"name":"Metabolism and Endocrinology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Setagaya-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzo","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Metabolism and Endocrinology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Setagaya-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,10]]},"reference":[{"key":"2025082704070700000_12.10.e231411.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5893.643"},{"key":"2025082704070700000_12.10.e231411.2","doi-asserted-by":"publisher","DOI":"10.1089\/105072503322238854"},{"key":"2025082704070700000_12.10.e231411.3","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1210\/er.2015-1106","article-title":"Role of thyroid hormones in skeletal development and bone maintenance","volume":"37","author":"Bassett","year":"2016","journal-title":"Endocr Rev"},{"key":"2025082704070700000_12.10.e231411.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(71)91122-6"},{"key":"2025082704070700000_12.10.e231411.5","doi-asserted-by":"publisher","DOI":"10.1016\/0009-9120(94)90014-0"},{"key":"2025082704070700000_12.10.e231411.6","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9384"},{"key":"2025082704070700000_12.10.e231411.7","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.surg.2017.09.008","article-title":"Is hungry bone syndrome a cause of postoperative hypocalcemia after total thyroidectomy in thyrotoxicosis? A prospective study with bone mineral density correlation","volume":"163","author":"Karunakaran","year":"2018","journal-title":"Surgery"},{"key":"2025082704070700000_12.10.e231411.8","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2014-206967","article-title":"Calcium maelstrom: recalcitrant hypocalcaemia following rapid correction of thyrotoxicosis, exacerbated by pregnancy","volume":"2015","author":"Shin","year":"2015","journal-title":"BMJ Case Rep"},{"key":"2025082704070700000_12.10.e231411.9","first-page":"1177","article-title":"A case of hungry bone syndrome following thyroidectomy for Graves' disease","volume":"95","author":"Ota","year":"2002","journal-title":"Pract Otorhinolaryngol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-231411","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:07:14Z","timestamp":1756292834000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-231411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":9,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2019,10,10]]},"published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1136\/bcr-2019-231411"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-231411","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10]]}}}