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{{Hypoparathyroidism}}
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
{{CMG}}; {{AE}} {{Anmol}}
{{SK}} Hypoparathyroid, parathyroid hormone levels decreased, parathyroid related hypocalcemia, underactive parathyroid glands
{{Infobox_Disease |
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   MeshID        = D007011  |
   MeshID        = D007011  |
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==[[Hypoparathyroidism overview|Overview]]==
 
==[[Hypoparathyroidism historical perspective|Historical Perspective]]==


==Overview==
==[[Hypoparathyroidism classification|Classification]]==
'''Hypoparathyroidism''' is decreased function of the [[parathyroid gland]]s, leading to decreased levels of [[parathyroid hormone]] ([[PTH]]). The consequence, [[hypocalcemia]], is a serious medical condition.


==Signs and symptoms==
==[[Hypoparathyroidism pathophysiology|Pathophysiology]]==
[[Hypocalcemia]] is the only real result of parathyroid dysfunction and low PTH levels. This presents with [[tremor]], [[tetany]] and, eventually, [[convulsion]]s.


In contrast to [[hyperparathyroidism]] (hyperfunction of the parathyroids), hypoparathyroidism does not have consequences for [[bone]].
==[[Hypoparathyroidism causes|Causes]]==


==Diagnosis==
==[[Hypoparathyroidism differential diagnosis|Differentiating Hypoparathyroidism from other Diseases]]==
Diagnosis is by measurement of [[calcium]], [[serum albumin]] (for correction) and [[PTH]] in [[blood test|blood]]. [[PTH]] degrades rapidly at ambient temperatures and the blood sample therefore has to be transported to the laboratory on ice.
 
==[[Hypoparathyroidism epidemiology and demographics|Epidemiology and Demographics]]==


If necessary, measuring [[Cyclic adenosine monophosphate|cAMP]] ([[cyclic AMP]]) in the urine after an intravenous dose of [[PTH]] can help in the distinction between [[hypoparathyroidism]] and other causes.
==[[Hypoparathyroidism risk factors|Risk Factors]]==


Differential diagnoses are:
==[[Hypoparathyroidism screening|Screening]]==
* [[Pseudohypoparathyroidism]] (normal [[PTH]] levels but tissue insensitivity to the hormone, associated with [[mental retardation]] and [[skeleton|skeletal deformities]]) and [[pseudopseudohypoparathyroidism]] (''sic'').
* Deficiency of [[Vitamin D]] or hereditary insensitivity to this vitamin (X-linked dominant).
* [[Malabsorption]]
* [[Kidney disease]]
* Medication: [[steroid]]s, [[diuretic]]s, some [[antiepileptic]]s.


==Causes==
==[[Hypoparathyroidism natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
Hypoparathyroidism can have a number of divergent causes:
 
* Removal of the parathyroid glands in [[thyroid]] surgery ([[thyroidectomy]]) is a recognised cause. It is now uncommon, as [[surgery|surgeon]]s generally spare them during the procedure after identifying them.
==Diagnosis==
* [[Autoimmune disorder|Autoimmune]] invasion and destruction is the most common non-surgical cause. It can occur as part of [[autoimmune polyendocrine syndrome]]s.
[[Hypoparathyroidism history and symptoms|History and Symptoms]] | [[Hypoparathyroidism physical examination|Physical Examination]] | [[Hypoparathyroidism laboratory findings|Laboratory Findings]] | [[Hypoparathyroidism electrocardiogram|Electrocardiogram]] | [[Hypoparathyroidism x ray|X Ray]] | [[Hypoparathyroidism CT|CT]] | [[Hypoparathyroidism MRI|MRI]] | [[Hypoparathyroidism echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Hypoparathyroidism other imaging findings|Other Imaging Findings]] | [[Hypoparathyroidism other diagnostic studies|Other Diagnostic Studies]]
* [[Hemochromatosis]] can lead to iron accumulation and consequent dysfunction of a number of endocrine organs, including the parathyroids.
* Absence or dysfunction of the parathyroid glands is one of the components of [[Chromosome 22, microdeletion 22 q11|chromosome 22q11 microdeletion syndrome]] (other names: DiGeorge syndrome, Schprintzen syndrome, velocardiofacial syndrome).
* [[Magnesium]] deficiency
* Some very [[rare disease]]s
* Idiopathic (of unknown cause), occasionally familial


==Treatment==
==Treatment==
Severe hypocalcemia, a potentially life-threatening condition,  is treated as soon as possible with [[intravenous]] [[calcium]] (e.g. as [[calcium gluconate]]). Generally, a central venous catheter is recommended, as the calcium can irritate [[peripheral vein]]s and cause [[phlebitis]].
[[Hypoparathyroidism medical therapy|Medical Therapy]] | [[Hypoparathyroidism surgery|Surgery]] | [[Hypoparathyroidism primary prevention|Primary Prevention]] | [[Hypoparathyroidism secondary prevention|Secondary Prevention]] | [[Hypoparathyroidism cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Hypoparathyroidism future or investigational therapies|Future or Investigational Therapies]]


Long-term treatment of hypoparathyroidism is with calcium and [[Vitamin D3]] supplementation (D1 is ineffective in the absence of renal conversion). [[Teriparatide]], a synthetic form of PTH (presently registered for [[osteoporosis]]) might become the treatment of choice for PTH supplementation, although further studies are awaited.
==Case Studies==
[[Hypoparathyroidism case study one|Case #1]]


==See also==
==Related Chapters==
* [[Hyperparathyroidism]]
* [[Hyperparathyroidism]]
* [[Pseudopseudohypoparathyroidism]]
* [[Pseudopseudohypoparathyroidism]]
* [[Hypocalcemia]]
* [[Parathyroid disorders]]
==References==
{{reflist|2}}


{{Endocrine pathology}}
{{Endocrine pathology}}
[[Category:Parathyroid disorders]]
[[Category:Endocrinology]]
{{SIB}}
[[es:Hipoparatiroidismo]]
[[es:Hipoparatiroidismo]]
[[fr:Hypoparathyroïdie]]
[[fr:Hypoparathyroïdie]]
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Latest revision as of 22:18, 29 July 2020

Hypoparathyroidism Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypoparathyroidism from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

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Treatment

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Cost-Effectiveness of Therapy

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For patient information click here 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]

Synonyms and keywords: Hypoparathyroid, parathyroid hormone levels decreased, parathyroid related hypocalcemia, underactive parathyroid glands

Hypoparathyroidism
ICD-10 E20, E89.2, P71.4
ICD-9 252.1
DiseasesDB 6490
MeSH D007011

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypoparathyroidism from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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References

sv:Hypoparathyreoidism


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