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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Hypoparathyroidism natural history, complications and prognosis

Introduction

Overview

Overview

The symptoms and complications of hypoparathyroidism usually develop due to hypocalcemia.There is an increased risk of renal complications due to hypercalciuria in patients treated with calcium and vitamin D analogs. Majority of post-surgical patients have transient hypoparathyroidism. The prognosis of post-surgical hypoparathyroidism is usually good as it is transient and serum calcium levels becomes normal within 6 months of surgery. Hypocalcemia due to hypoparathyroidism leads to complications irrespective of treatment. These complications include renal complications and hypocalcemic seizures. Other complications include symptomatic hypocalcemia, basal ganglia calcifications, complications of intravenous calcium extravasation, dilated cardiomyopathy, pathological fractures. Patients on treatment of hypoparathyroidism should be actively monitored for hypercalciuria and renal complications by renal imaging and creatinine clearance.

Natural History, Complications, and Prognosis

Natural History, Complications, and Prognosis

Natural History

  • The symptoms and complications of hypoparathyroidism usually develop due to hypocalcemia.[1]
  • There is an increased risk of renal complications due to hypercalciuria in patients treated with calcium and vitamin D analogs.
  • Transient hypoparathyroidism:[2][3][4]
    • Most common cause of hypoparathyroidism is anterior neck surgery.
    • Majority of post-surgical patients have transient hypoparathyroidism.
    • This hypoparathyroidism is due to post-surgical “stunning of parathyroid glands“.
  • The features of hypoparathyroidism should persist for atleast 6 month after surgery to be diagnosed as chronic hypoparathyroidism.
  • Hypocalcemia due to hypoparathyroidism leads to complications irrespective of treatment. The common complications include renal complications and hypocalcemic seizures.[1]

Complications

Prognosis

References

References

  1. ↑ 1.0 1.1 1.2 1.3 Mitchell DM, Regan S, Cooley MR, Lauter KB, Vrla MC, Becker CB, Burnett-Bowie SA, Mannstadt M (2012). “Long-term follow-up of patients with hypoparathyroidism”. J. Clin. Endocrinol. Metab. 97 (12): 4507–14. doi:10.1210/jc.2012-1808. PMC 3513540. PMID 23043192.
  2. ↑ Bilezikian JP, Khan A, Potts JT, Brandi ML, Clarke BL, Shoback D, Jüppner H, D’Amour P, Fox J, Rejnmark L, Mosekilde L, Rubin MR, Dempster D, Gafni R, Collins MT, Sliney J, Sanders J (2011). “Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research”. J. Bone Miner. Res. 26 (10): 2317–37. doi:10.1002/jbmr.483. PMC 3405491. PMID 21812031.
  3. ↑ 3.0 3.1 Ritter K, Elfenbein D, Schneider DF, Chen H, Sippel RS (2015). “Hypoparathyroidism after total thyroidectomy: incidence and resolution”. J. Surg. Res. 197 (2): 348–53. doi:10.1016/j.jss.2015.04.059. PMC 4466142. PMID 25982044.
  4. ↑ 4.0 4.1 Sturniolo G, Lo Schiavo MG, Tonante A, D’Alia C, Bonanno L (2000). “Hypocalcemia and hypoparathyroidism after total thyroidectomy: a clinical biological study and surgical considerations”. Int. J. Surg. Investig. 2 (2): 99–105. PMID 12678507.
  5. ↑ Brandi ML, Bilezikian JP, Shoback D, Bouillon R, Clarke BL, Thakker RV, Khan AA, Potts JT (2016). “Management of Hypoparathyroidism: Summary Statement and Guidelines”. J. Clin. Endocrinol. Metab. 101 (6): 2273–83. doi:10.1210/jc.2015-3907. PMID 26943719.
  6. ↑ Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L (2014). “Postsurgical hypoparathyroidism–risk of fractures, psychiatric diseases, cancer, cataract, and infections”. J. Bone Miner. Res. 29 (11): 2504–10. doi:10.1002/jbmr.2273. PMID 24806578.
  7. ↑ Abate EG, Clarke BL (2016). “Review of Hypoparathyroidism”. Front Endocrinol (Lausanne). 7: 172. doi:10.3389/fendo.2016.00172. PMC 5237638. PMID 28138323.
  8. ↑ Goswami R, Sharma R, Sreenivas V, Gupta N, Ganapathy A, Das S (2012). “Prevalence and progression of basal ganglia calcification and its pathogenic mechanism in patients with idiopathic hypoparathyroidism”. Clin. Endocrinol. (Oxf). 77 (2): 200–6. doi:10.1111/j.1365-2265.2012.04353.x. PMID 22288727.
  9. ↑ Cho NL, Moalem J, Chen L, Lubitz CC, Moore FD, Ruan DT (2014). “Surgeons and patients disagree on the potential consequences from hypoparathyroidism”. Endocr Pract. 20 (5): 427–46. doi:10.4158/EP13321.OR. PMID 24325999.
  10. ↑ Arlt W, Fremerey C, Callies F, Reincke M, Schneider P, Timmermann W, Allolio B (2002). “Well-being, mood and calcium homeostasis in patients with hypoparathyroidism receiving standard treatment with calcium and vitamin D”. Eur. J. Endocrinol. 146 (2): 215–22. PMID 11834431.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]