Pseudohypoparathyroidism medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
*The mainstay of treatment for pseudohypoparathyroidism is oral [[calcium]] and 1alpha-hydroxylated vitamin D metabolites, such as [[calcitriol]]. | *The mainstay of treatment for pseudohypoparathyroidism is oral [[calcium]] and 1alpha-hydroxylated vitamin D metabolites, such as [[calcitriol]]. | ||
*Other forms of Vitamin D cannot be used as [[parathyroid]] hormone resistance in the [[proximal tubule]] decreases the | *Other forms of Vitamin D cannot be used as [[parathyroid]] hormone resistance in the [[proximal tubule]] decreases the production of 1,25(OH)2 vitamin D from 25-hydroxyvitamin D.Intravenous calcium is recommended for all patients who develop severe symptomatic [[hypocalcemia]]. | ||
*The majority of cases of pseudohypoparathyroidism are self-limited and require only supportive care. | *The majority of cases of pseudohypoparathyroidism are self-limited and require only supportive care. | ||
* The goal of therapy is to: | * The goal of therapy is to: | ||
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*'''''For [[neonates]], [[infants]], and [[children]]''''' | *'''''For [[neonates]], [[infants]], and [[children]]''''' | ||
** Preferred regimen (1):10% [[calcium gluconate]] 0.5-1 mL/kg of administered over 5 minutes. | ** Preferred regimen (1):10% [[calcium gluconate]] 0.5-1 mL/kg of administered over 5 minutes. | ||
==References== | ==References== | ||
Revision as of 15:40, 2 October 2017
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Pseudohypoparathyroidism Microchapters |
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Differentiating Pseudohypoparathyroidism from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Pseudohypoparathyroidism medical therapy On the Web |
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American Roentgen Ray Society Images of Pseudohypoparathyroidism medical therapy |
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Risk calculators and risk factors for Pseudohypoparathyroidism medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overview
The mainstay of treatment for pseudohypoparathyroidism is oral calcium and 1alpha-hydroxylated vitamin D analogues, such as calcitriol. Other forms of Vitamin D cannot be used as parathyroid hormone resistance in the proximal tubule decreases the efficiency of production of 1,25(OH)2 vitamin D from 25-hydroxyvitamin D.Intravenous calcium is recommended for all patients who develop severe symptomatic hypocalcemia.
Medical Therapy
- The mainstay of treatment for pseudohypoparathyroidism is oral calcium and 1alpha-hydroxylated vitamin D metabolites, such as calcitriol.
- Other forms of Vitamin D cannot be used as parathyroid hormone resistance in the proximal tubule decreases the production of 1,25(OH)2 vitamin D from 25-hydroxyvitamin D.Intravenous calcium is recommended for all patients who develop severe symptomatic hypocalcemia.
- The majority of cases of pseudohypoparathyroidism are self-limited and require only supportive care.
- The goal of therapy is to:
- Serum calcium within the normal range to prevent hypercalciuria
- Maintain parathyroid hormone levels within reference range which helps prevent bone remodeling and hyperparathyroid bone disease
- Intravenous calcium is recommended for all patients who develop severe symptomatic hypocalcemia.
- Adult
- Preferred regimen (1):elemental calcium (either calcium chloride or calcium gluconate) 100 mg of over 10 to 20 minute
- An additional dose of 100 mg/hr of elemental calcium can be infused if symptoms do not resolve, with close monitoring of calcium levels
- Cardiac monitoring may help to guide therapy as rapid infusion of calcium can cause cardiac conduction defects;
- Preferred regimen (2):Parenteral formulations available are calcium chloride and calcium gluconate 100 mg of over 10 to 20 minute
- 10% calcium chloride a 10-mL ampule contains 360 mg of elemental calcium
- 10% calcium gluconate 10-mL ampule contains 93 mg of elemental calcium.
- For neonates, infants, and children
- Preferred regimen (1):10% calcium gluconate 0.5-1 mL/kg of administered over 5 minutes.