IN THE UNITED STATES1
In ≈75% of cases, chronic hypoparathyroidism is caused by damage to or removal of the parathyroid glands during surgery of the thyroid, parathyroid, or adjacent neck structures. After such surgeries, regular monitoring of serum calcium levels is necessary to determine whether a patient’s hypoparathyroidism is transient or chronic. If it is still present 6 months after surgery, then it can be diagnosed as chronic hypoparathyroidism.1,4
Autoimmune hypoparathyroidism may be isolated or part of an autoimmune polyglandular syndrome (APS). Genetic mutations may involve parathyroid development, PTH synthesis, or resistance to PTH in the proximal renal tubule. Hypoparathyroidism is a feature in some complex congenital syndromes, such as DiGeorge syndrome. Excess accumulation of iron (thalassemia or hemochromatosis) or copper (Wilson’s disease) is another possible, less common cause.1,2
Signs and Symptoms of Chronic Hypoparathyroidism
The neurologic, cognitive, muscular, and cardiac systems can be affected in subtle or life-threatening ways in a person with hypoparathyroidism who has hypocalcemia.1-5
- Tingling of fingers and toes (paresthesias)
- Muscle cramps, laryngospasms, and seizures
- Muscle spasms, twitching, and cramping
- Carpopedal spasms and weakness
- Confusion and disorientation also referred to as "brain fog"
- Inability to focus/concentrate
- Increased anxiety
- Pseudotumor cerebri
- Basal ganglia calcifications
- Most symptoms and signs of hypocalcemia
- Cardiac rhythm disturbances (prolonged QT interval)
Progression of uncontrolled hypoparathyroidism1,3,4
Over time, hypoparathyroidism and its treatment can lead to complications, some of which are life-threatening:
- Malformations of teeth
- Intracranial calcifications
- Renal stones
- Renal failure
- Bone density changes and remodeling
PUBLISHED LITERATURE ON HYPOPARATHYROIDISM ETIOLOGY AND PROGRESSION OF DISEASE
Bilezikian et al.
Hypoparathyroidism in the adult: Epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research.
Brandi et al.
Management of hypoparathyroidism: Summary statement and guidelines.
Shoback et al.
Presentation of hypoparathyroidism: Etiologies and clinical features.
PubMed® is a registered trademark of the US National Library of Medicine.
Brandi ML, et al. J Clin Endocrinol Metab. 2016;101(6):2273-2283.
Bilezikian JP, et al. J Bone Miner Res. 2011;26(10):2317-2337.
Shoback DM, et al. J Clin Endocrinol Metab. 2016;101(6):2300-2312.
Monis EL, Mannstadt M. Ann Endocrinol (Paris). 2015;76(2):84-88.
Bollerslev J, et al; European Society of Endocrinology. Eur J Endocrinol. 2015;173(2):G1-G20.