Multiple endocrine neoplasia type 1
ICD-10 E31.8 · ICD-11 2F7A.0.1

Treatment of MEN1 with Hypoparathyroidism Following Parathyroidectomy

Patients with Multiple endocrine neoplasia type 1 (MEN1) who undergo parathyroidectomy for MEN1-related primary hyperparathyroidism may develop hypoparathyroidism as a post-surgical complication. This scenario requires a targeted management approach to restore calcium homeostasis while minimising risk.

Clinical Situation

Hypoparathyroidism following parathyroidectomy for MEN1-related primary hyperparathyroidism. The absence of adequate parathyroid hormone activity leads to hypocalcaemia that warrants active correction within a carefully defined target range.

Treatment Approach (partial)

Management involves calcium supplementation together with an active vitamin D analogue. The approach follows the same principles established in international guidelines for sporadic hypoparathyroidism. The complete regimen, including the specific agents selected, sequencing, and monitoring parameters, is detailed in the full protocol.

Treatment Goals

Raise serum calcium to the lower half of, or just below, the normal reference range — alleviating symptomatic hypocalcaemia while avoiding hypercalciuria.

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References

DOI: 10.1016/S2213-8587(25)00119-6

The management of hypoparathyroidism in MEN1 follows the same principles outlined in international guidelines for sporadic disease, and includes treatment with calcium and an active vitamin D analogue, with the goal of raising serum calcium to the lower half of the normal reference range or just below the normal reference range, and alleviating symptomatic hypocalcaemia, while avoiding hypercalciuria.

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