Hungry Bone Syndrome in the Postoperative Management of Primary Hyperparathyroidism: Report of Two Cases

Abstract Introduction: Hungry Bone Syndrome (HBS) is a rare but potentially severe metabolic complication following parathyroidectomy, occurring mainly in patients with severe primary hyperparathyroidism (PHPT) and high bone turnover [1–3]. Case Reports: We report two cases of HBS occurring after parathyroidectomy for advanced primary hyperparathyroidism. Both patients presented with marked preoperative hypercalcemia, very high parathyroid hormone (PTH) levels, and clinical and biological features of increased bone turnover. The postoperative course was characterized by prolonged hypocalcemia associated with hypophosphatemia, requiring intensive calcium and vitamin D supplementation. Conclusion: HBS should be anticipated in high-risk patients undergoing parathyroidectomy. Early recognition and appropriate management are essential to reduce postoperative morbidity.