• Clinical science

Hypoparathyroidism

Abstract

Hypoparathyroidism may be due to a variety of mechanisms, including destruction of parathyroid glands (autoimmune or surgical), abnormal parathyroid gland development, altered regulation of parathyroid hormone (PTH), or impaired PTH action on end organs. The resulting hypocalcemia can trigger a variety of symptoms, ranging from muscle cramps to seizures or heart failure. Manifestations of chronic hypoparathyroidism, however, are quite specific, and include basal ganglia calcifications (resulting in movement disorders), cataracts, and skeletal and dental abnormalities. Laboratory findings in hypoparathyroidism include hypocalcemia with low or inappropriately normal PTH, hyperphosphatemia, and normal renal function. Treatment usually includes correcting the hypocalcemia through calcium and vitamin D supplementation and treatment of the underlying cause.

Etiology

References:[1][2]

Clinical features

References:[2][3]

Diagnostics

References:[2][3]

Differential diagnoses

See differential diagnosis of hypocalcemia.

The differential diagnoses listed here are not exhaustive.

Treatment

  • Treat underlying disease
  • Calcium and vitamin D supplementation
  • Recombinant human PTH is still an experimental treatment, but it can reduce the amount of supplemental calcium and vitamin D required.

References:[2]

  • 1. Kasper DL, Fauci AS, Hauser SL, Longo DL, Lameson JL, Loscalzo J. Harrison's Principles of Internal Medicine. New York, NY: McGraw-Hill Education; 2015.
  • 2. Goltzman D. Hypoparathyroidism. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/hypoparathyroidism. Last updated April 22, 2015. Accessed February 19, 2017.
  • 3. Gonzalez-Campoy JM. Hypoparathyroidism. In: Hypoparathyroidism. New York, NY: WebMD. http://emedicine.medscape.com/article/122207. Updated July 25, 2016. Accessed February 19, 2017.
  • Jesus JE, Landry A. Chvostek's and Trousseau's signs. N Engl J Med. 2012; 367(11): p. e15. doi: 10.1056/nejmicm1110569.
last updated 10/22/2018
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