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Wiadomosci lekarskie (Warsaw, Poland : 1960)

[Hypoparathyroidism: the present state of art].


PMID 23905424

Abstract

Hypoparathyroidism is a result of reduced secretion or impaired action of parathyroid hormone (PTH). Although considered a rare condition, hypoparathyroidism seems to occur much more frequently than reported. In most cases, hypoparathyroidism remains a complication of neck surgery. However, there is a growing incidence of the autoimmune form of hypoparathyroidism, which may occur in combination with other autoimmune diseases. As parathyroid glands are necessary to sustain life and maintain homeostasis, undetected or misdiagnosed hypoparathyroidism may pose a significant threat to health outcomes, as its presence may increase morbidity and mortality in affected individuals. The clinical consequences of PTH deficiency or impaired receptor action are multidirectional and include nervous hyperexcitability, paresthesias, cramps, tetany, hyperreflexia, convulsions, cataract, weakened tooth enamel, brittle nails and basal ganglia calcifications. In some patients, however, its manifestation may be non-specific, and in these cases the correct diagnosis may be easily missed. Laboratory measurements show hypocalcemia, hyperphosphatemia, and, with the exception of pseudohypoparathyroidism, inappropriately low or undetectable PTH levels. Treatment consists of oral calcium supplementation and vitamin D derivatives. In this review article, we discuss the causes, clinical picture, diagnosis and treatment of hypoparathyroidism and provide the reader with some practical guidance concerning dealing with a patient suffering from this disorder.