<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2182-5173</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Medicina Geral e Familiar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Port Med Geral Fam]]></abbrev-journal-title>
<issn>2182-5173</issn>
<publisher>
<publisher-name><![CDATA[Associação Portuguesa de Medicina Geral e Familiar]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2182-51732022000500517</article-id>
<article-id pub-id-type="doi">10.32385/rpmgf.v38i5.13284</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Hipocalcemia sintomática em cuidados de saúde primários: a propósito de um caso clínico]]></article-title>
<article-title xml:lang="en"><![CDATA[Symptomatic hypocalcemia in primary health care: review and clinical case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cardoso]]></surname>
<given-names><![CDATA[Graça]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Ana Luísa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Varandas]]></surname>
<given-names><![CDATA[Ana Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Lígia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,ACeS Maia-Valongo USF Bela Saúde ]]></institution>
<addr-line><![CDATA[Ermesinde ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,ACeS Maia-Valongo USF Bela Saúde ]]></institution>
<addr-line><![CDATA[Ermesinde ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,ACeS Maia-Valongo USF Bela Saúde ]]></institution>
<addr-line><![CDATA[Ermesinde ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>31</day>
<month>10</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>31</day>
<month>10</month>
<year>2022</year>
</pub-date>
<volume>38</volume>
<numero>5</numero>
<fpage>517</fpage>
<lpage>522</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2182-51732022000500517&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2182-51732022000500517&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2182-51732022000500517&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  O hipoparatiroidismo é uma causa de hipocalcemia, sendo a sua principal etiologia a exérese inadvertida/lesão das paratiroides aquando da tiroidectomia total. Habitualmente os sintomas manifestam-se no período pós-operatório imediato, sendo rara a sua manifestação anos após a cirurgia. Atendendo à sua forma de apresentação inespecífica, no caso de uma manifestação tardia, o seu diagnóstico requer elevado grau de suspeição. Assim, pretende-se apresentar um caso de hipocalcemia tardia, alertando-se para a sua sintomatologia inespecífica e consequente dificuldade de diagnóstico no âmbito dos cuidados de saúde primários de uma situação que pode ser potencialmente grave ou até fatal.  Descrição do caso:  Doente submetida a tiroidectomia por carcinoma papilar da tiroide, com paratiroidectomia parcial incidental em 2010, seguida de terapêutica com iodo radioativo. Desde 2016 com mialgias, parestesias das mãos e ansiedade com agravamento progressivo. Em 2019, por quadro de ansiedade extrema e tetania dos membros superiores, foi enviada ao serviço de urgência, onde foi diagnosticada hipocalcemia grave por iatrogenia pós tiroidectomia total de apresentação tardia.  Comentário:  Esta é uma condição rara, que pode mimetizar um amplo espectro de doenças do foro músculo-esquelético, neurológico ou psiquiátrico. Deve pesquisar-se sinal de Trousseau e Chvostek, confirmando-se diagnóstico com cálcio e hormona paratiroideia, seguindo-se tratamento com cálcio e vitamina D. Em situações agudas é necessária avaliação em serviço de urgência. Este caso retrata a importância do médico de família na avaliação de sintomas inespecíficos que, a par dos antecedentes e observação semiológica cuidada, poderão fazer suspeitar de diagnósticos incomuns, mas potencialmente fatais.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Hypoparathyroidism is a cause of hypocalcemia and its main etiology is inadvertent exeresis/injury of the parathyroids during total thyroidectomy. Symptoms usually manifest in the immediate postoperative period, and it&#8217;s rare its start years after surgery. Given its nonspecific presentation, in the case of a late manifestation, the diagnosis requires a high degree of suspicion. Thus, we intend to present a case of late hypocalcemia, alerting to its non-specific symptoms and consequent difficulty in diagnosing a situation that can be potentially serious or even fatal within the scope of primary health care.  Case description:  Patient undergoing thyroidectomy for carcinoma, with inadvertent partial parathyroidectomy in 2010, followed by radioactive iodine therapy. Since 2016 with myalgia, paresthesia of hands, and anxiety with progressive worsening. In 2019, due to extreme anxiety and tetany of upper limbs, she was sent to the emergency department where severe hypocalcemia due to iatrogenesis after total thyroidectomy of the late presentation was diagnosed.  Discussion:  This is a rare condition, which can mimic a wide spectrum of diseases, musculoskeletal, neurological, or psychiatric. Trousseau and Chvostek&#8217;s signs should be investigated, confirming the diagnosis with calcium and parathyroid hormone, followed by treatment with calcium and vitamin D. In acute situations, evaluation in the emergency department is necessary. This case portrays the importance of the family physicians in the evaluation of nonspecific symptoms that, together with the patient&#8217;s history and careful semiological observation, may rise suspicions of uncommon, but potentially fatal, diagnoses.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Tiroidectomia]]></kwd>
<kwd lng="pt"><![CDATA[Hipoparatiroidismo]]></kwd>
<kwd lng="pt"><![CDATA[Hipocalcemia]]></kwd>
<kwd lng="pt"><![CDATA[Relato de caso]]></kwd>
<kwd lng="en"><![CDATA[Thyroidectomy]]></kwd>
<kwd lng="en"><![CDATA[Hypoparathyroidism]]></kwd>
<kwd lng="en"><![CDATA[Hypocalcemia]]></kwd>
<kwd lng="en"><![CDATA[Case report]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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