Hypoparathyroidism: Difference between revisions

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

	Hypoparathyroidism Microchapters
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Overview
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Differentiating Hypoparathyroidism from other Diseases
Epidemiology and Demographics
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Diagnosis
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Physical Examination
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Electrocardiogram
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Latest revision as of 22:18, 29 July 2020

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

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypoparathyroidism from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Treatment

Case Studies

Case #1

Related Chapters

References

sv:Hypoparathyreoidism

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+{{Hypoparathyroidism}}
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+{{SK}} Hypoparathyroid, parathyroid hormone levels decreased, parathyroid related hypocalcemia, underactive parathyroid glands
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-{{Hypoparathyroidism}}
-{{CMG}}
+==[[Hypoparathyroidism overview|Overview]]==
+==[[Hypoparathyroidism historical perspective|Historical Perspective]]==
+==[[Hypoparathyroidism classification|Classification]]==
+==[[Hypoparathyroidism pathophysiology|Pathophysiology]]==
+==[[Hypoparathyroidism causes|Causes]]==
-==Signs and symptoms==
+==[[Hypoparathyroidism differential diagnosis|Differentiating Hypoparathyroidism from other Diseases]]==
-[[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 epidemiology and demographics|Epidemiology and Demographics]]==
-==Diagnosis==
+==[[Hypoparathyroidism risk factors|Risk Factors]]==
-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.
-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 screening|Screening]]==
-Differential diagnoses are:
+==[[Hypoparathyroidism natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
-* [[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==
+==Diagnosis==
-Hypoparathyroidism can have a number of divergent causes:
+[[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]]
-* 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.
-* [[Autoimmune disorder|Autoimmune]] invasion and destruction is the most common non-surgical cause. It can occur as part of [[autoimmune polyendocrine syndrome]]s.
-* [[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==
-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]]
 ==Related Chapters==
 * [[Hyperparathyroidism]]
 * [[Pseudopseudohypoparathyroidism]]
+* [[Hypocalcemia]]
+* [[Parathyroid disorders]]
+==References==
+{{reflist|2}}
 {{Endocrine pathology}}
-[[Category:Parathyroid disorders]]
-[[Category:Endocrinology]]
-[[Category:Disease]]
 [[es:Hipoparatiroidismo]]
 [[fr:Hypoparathyroïdie]]
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+[[Category:Disease]]
+[[Category:Medicine]]
+[[Category:Endocrinology]]
+[[Category:Parathyroid disorders]]
+[[Category:Up-To-Date]]

v t e Endocrine pathology: endocrine diseases (E00-35, 240-259)
Thyroid	Hypothyroidism (Iodine deficiency, Cretinism, Congenital hypothyroidism, Goitre, Myxedema) - Hyperthyroidism (Graves disease, Toxic multinodular goitre, Teratoma with thyroid tissue or Struma ovarii) - Thyroiditis (De Quervain's thyroiditis, Hashimoto's thyroiditis, Riedel's thyroiditis) - Euthyroid sick syndrome
Pancreas	Diabetes mellitus (type 1, type 2, coma, angiopathy, ketoacidosis, nephropathy, neuropathy, retinopathy) - Hypoglycemia - Hyperinsulinism - Zollinger-Ellison syndrome - insulin receptor (Rabson-Mendenhall syndrome)
Parathyroid	Hypoparathyroidism (Pseudohypoparathyroidism) - Hyperparathyroidism (Primary, Secondary, Tertiary)
Pituitary	Hyperpituitarism (Acromegaly, Hyperprolactinaemia, SIADH) - Hypopituitarism (Simmonds' disease / Sheehan's syndrome, Kallmann syndrome, Growth hormone deficiency, Diabetes insipidus) - Adiposogenital dystrophy - Empty sella syndrome - Hypophysitis
Adrenal	Cushing's syndrome (Nelson's syndrome, Pseudo-Cushing's syndrome) - CAH (Lipoid, 3β, 11β, 17α, 21α) - Hyperaldosteronism (Conn syndrome, Bartter syndrome) - Adrenal insufficiency (Addison's disease) - Hypoaldosteronism
Gonads	Ovarian dysfunction (Polycystic ovary syndrome, Premature ovarian failure) - Testicular dysfunction (5-alpha-reductase deficiency) - Testosterone biosynthesis (17-beta-hydroxysteroid dehydrogenase deficiency) - General (Hypogonadism, Delayed puberty, Precocious puberty)
Other	Androgen insensitivity syndrome - Autoimmune polyendocrine syndrome - Carcinoid syndrome - Gigantism - Short stature (Laron syndrome, Psychogenic dwarfism) - Multiple endocrine neoplasia (1, 2) - Progeria - Woodhouse-Sakati syndrome

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