Hypoparathyroidism history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
The hallmark of acute [[hypocalcemia]] due to [[hypoparathyroidism]] is [[tetany]]. A positive history of [[neck surgery]] and symptoms of [[hypocalcemia]] is suggestive of hypoparathyroidism. The most common symptoms of hypoparathyroidism include [[tetany]], [[paresthesia]], [[Carpopedal spasm|carpopedal spasms]], and circumoral numbness. Common symptoms of hypoparathyroidism include [[abdominal pain]], [[biliary colic | The hallmark of acute [[hypocalcemia]] due to [[hypoparathyroidism]] is [[tetany]]. A positive history of [[neck surgery]] and symptoms of [[hypocalcemia]] is suggestive of hypoparathyroidism. The most common symptoms of hypoparathyroidism include [[tetany]], [[paresthesia]], [[Carpopedal spasm|carpopedal spasms]], and circumoral numbness. Common symptoms of hypoparathyroidism include [[abdominal pain]], [[biliary colic]], [[fatigue]], [[muscle cramps]], [[Myoclonic jerk|myoclonic jerks]], new onset [[seizure]] due to [[hypocalcemia]] or worsening of [[Seizure|seizures]], and [[painful menstruation]]. Less common symptoms of hypoparathyroidism include [[Cognitive impairment|cognitive impairmen]]<nowiki/>t, [[decreased concentration]], [[hoarseness]], [[neuromuscular]] irritability, [[Palpitation|palpitations]], personality disturbances and/or mood changes, symptoms of acute [[cardiomyopathy]], [[Wheeze|wheezing]], and [[dyspnea]]. | ||
==History and Symptoms== | ==History and Symptoms== | ||
===History=== | ===History=== | ||
Patients with hypoparathyroidism may have a positive history of:<ref name="pmid7173823">{{cite journal |vauthors=Brun JM |title=Juvenile autoimmune polyendocrinopathy |journal=Horm. Res. |volume=16 |issue=5 |pages=308–16 |year=1982 |pmid=7173823 |doi= |url=}}</ref><ref name="pmid18650515">{{cite journal |vauthors=Shoback D |title=Clinical practice. Hypoparathyroidism |journal=N. Engl. J. Med. |volume=359 |issue=4 |pages=391–403 |year=2008 |pmid=18650515 |doi=10.1056/NEJMcp0803050 |url=}}</ref> | Patients with hypoparathyroidism may have a positive history of:<ref name="pmid7173823">{{cite journal |vauthors=Brun JM |title=Juvenile autoimmune polyendocrinopathy |journal=Horm. Res. |volume=16 |issue=5 |pages=308–16 |year=1982 |pmid=7173823 |doi= |url=}}</ref><ref name="pmid18650515">{{cite journal |vauthors=Shoback D |title=Clinical practice. Hypoparathyroidism |journal=N. Engl. J. Med. |volume=359 |issue=4 |pages=391–403 |year=2008 |pmid=18650515 |doi=10.1056/NEJMcp0803050 |url=}}</ref> | ||
* History of neck surgery | * History of [[neck surgery]] | ||
* A family history of hypocalcemia and/or hypoparathyroidism | * A family history of [[hypocalcemia]] and/or hypoparathyroidism | ||
* A history of other autoimmune endocrinopathies (e.g., adrenal insufficiency) | * A history of other [[Autoimmunity|autoimmune]] endocrinopathies (e.g., [[adrenal insufficiency]]) | ||
* A history of candidiasis | * A history of [[candidiasis]] | ||
* Immunodeficiency | * [[Immunodeficiency]] | ||
===Symptoms=== | ===Symptoms=== | ||
*Clinical symptoms depends on two features:<ref name="pmid28138323">{{cite journal |vauthors=Abate EG, Clarke BL |title=Review of Hypoparathyroidism |journal=Front Endocrinol (Lausanne) |volume=7 |issue= |pages=172 |year=2016 |pmid=28138323 |pmc=5237638 |doi=10.3389/fendo.2016.00172 |url=}}</ref> | *Clinical symptoms depends on two features:<ref name="pmid28138323">{{cite journal |vauthors=Abate EG, Clarke BL |title=Review of Hypoparathyroidism |journal=Front Endocrinol (Lausanne) |volume=7 |issue= |pages=172 |year=2016 |pmid=28138323 |pmc=5237638 |doi=10.3389/fendo.2016.00172 |url=}}</ref> | ||
**Acuteness of hypocalcemia | **Acuteness of [[hypocalcemia]] | ||
**The absolute level of serum calcium | **The absolute level of serum [[calcium]] | ||
*Patients presents dramatically and tends to have more symptoms if there is an acute | *Patients presents dramatically and tends to have more symptoms if there is an acute [[hypocalcemia]] compared to patients with chronic [[hypocalcemia]].<ref name="pmid8325292">{{cite journal |vauthors=Tohme JF, Bilezikian JP |title=Hypocalcemic emergencies |journal=Endocrinol. Metab. Clin. North Am. |volume=22 |issue=2 |pages=363–75 |year=1993 |pmid=8325292 |doi= |url=}}</ref> | ||
====Common symptoms==== | ====Common symptoms==== | ||
Common symptoms of hypoparathyroidism include:<ref name="pmid28138323">{{cite journal |vauthors=Abate EG, Clarke BL |title=Review of Hypoparathyroidism |journal=Front Endocrinol (Lausanne) |volume=7 |issue= |pages=172 |year=2016 |pmid=28138323 |pmc=5237638 |doi=10.3389/fendo.2016.00172 |url=}}</ref><ref name="pmid18535072">{{cite journal |vauthors=Cooper MS, Gittoes NJ |title=Diagnosis and management of hypocalcaemia |journal=BMJ |volume=336 |issue=7656 |pages=1298–302 |year=2008 |pmid=18535072 |pmc=2413335 |doi=10.1136/bmj.39582.589433.BE |url=}}</ref> | Common symptoms of hypoparathyroidism include:<ref name="pmid28138323">{{cite journal |vauthors=Abate EG, Clarke BL |title=Review of Hypoparathyroidism |journal=Front Endocrinol (Lausanne) |volume=7 |issue= |pages=172 |year=2016 |pmid=28138323 |pmc=5237638 |doi=10.3389/fendo.2016.00172 |url=}}</ref><ref name="pmid18535072">{{cite journal |vauthors=Cooper MS, Gittoes NJ |title=Diagnosis and management of hypocalcaemia |journal=BMJ |volume=336 |issue=7656 |pages=1298–302 |year=2008 |pmid=18535072 |pmc=2413335 |doi=10.1136/bmj.39582.589433.BE |url=}}</ref> | ||
*Tetany (hallmark of acute hypocalcemia) | *[[Tetany]] (hallmark of acute [[hypocalcemia]]) | ||
*Paresthesia in fingertips, toes, perioral area | *[[Paresthesia]] in [[Fingertip|fingertips]], [[Toe|toes]], [[perioral]] area | ||
*Carpopedal spasms | *[[Carpopedal spasm|Carpopedal spasms]] | ||
*Circumoral numbness | *Circumoral [[numbness]] | ||
*Abdominal pain | *[[Abdominal pain]] | ||
*Biliary colic | *[[Biliary colic]] | ||
* | *[[Fatigue]] | ||
*[[Muscle cramps]] | |||
*Muscle cramps | *[[Myoclonic jerk|Myoclonic jerks]] | ||
*Myoclonic jerks | *New onset [[seizure]] due to [[hypocalcemia]] or worsening of [[Seizure|seizures]] | ||
*New onset seizure due to hypocalcemia or worsening of seizures | *[[Painful menstruation]] | ||
*Painful menstruation | |||
====Less common synptoms==== | ====Less common synptoms==== | ||
Less common symptoms of hypoparathyroidism include:<ref name="pmid28138323">{{cite journal |vauthors=Abate EG, Clarke BL |title=Review of Hypoparathyroidism |journal=Front Endocrinol (Lausanne) |volume=7 |issue= |pages=172 |year=2016 |pmid=28138323 |pmc=5237638 |doi=10.3389/fendo.2016.00172 |url=}}</ref><ref name="pmid18535072">{{cite journal |vauthors=Cooper MS, Gittoes NJ |title=Diagnosis and management of hypocalcaemia |journal=BMJ |volume=336 |issue=7656 |pages=1298–302 |year=2008 |pmid=18535072 |pmc=2413335 |doi=10.1136/bmj.39582.589433.BE |url=}}</ref> | Less common symptoms of hypoparathyroidism include:<ref name="pmid28138323">{{cite journal |vauthors=Abate EG, Clarke BL |title=Review of Hypoparathyroidism |journal=Front Endocrinol (Lausanne) |volume=7 |issue= |pages=172 |year=2016 |pmid=28138323 |pmc=5237638 |doi=10.3389/fendo.2016.00172 |url=}}</ref><ref name="pmid18535072">{{cite journal |vauthors=Cooper MS, Gittoes NJ |title=Diagnosis and management of hypocalcaemia |journal=BMJ |volume=336 |issue=7656 |pages=1298–302 |year=2008 |pmid=18535072 |pmc=2413335 |doi=10.1136/bmj.39582.589433.BE |url=}}</ref> | ||
*Cognitive impairment | *[[Cognitive impairment]] | ||
*Hoarseness (due to laryngospasm) | *[[Hoarseness]] (due to [[laryngospasm]]) | ||
*Neuromuscular irritability | *[[Neuromuscular]] irritability | ||
*Palpitations due cardiac dysarrhythmias | *[[Palpitation|Palpitations]] due [[cardiac]] dysarrhythmias | ||
*Personality disturbances and/or mood changes | *Personality disturbances and/or mood changes | ||
*Symptoms of acute cardiomyopathy | *Symptoms of acute [[cardiomyopathy]] | ||
*Wheezing and dyspnea (due to bronchospasm) | *[[Wheezing]] and [[dyspnea]] (due to [[bronchospasm]]) | ||
*Electrocardiographic changes that mimic myocardial infarction, or congestive heart failure (decreased cardiac contractility is related to low serum calcium and possibly parathyroid hormone deficiency, as | *Electrocardiographic changes that mimic [[myocardial infarction]], or [[congestive heart failure]] (decreased [[cardiac contractility]] is related to [[Hypocalcemia|low serum calcium]] and possibly parathyroid hormone deficiency, as parathyroid hormone receptors are present in [[cardiac myocytes]]).<ref name="pmid24919035">{{cite journal |vauthors=Kimura S, Yoshioka K |title=Parathyroid hormone and parathyroid hormone type-1 receptor accelerate myocyte differentiation |journal=Sci Rep |volume=4 |issue= |pages=5066 |year=2014 |pmid=24919035 |pmc=4052750 |doi=10.1038/srep05066 |url=}}</ref> | ||
==References== | ==References== | ||
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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]
Overview
The hallmark of acute hypocalcemia due to hypoparathyroidism is tetany. A positive history of neck surgery and symptoms of hypocalcemia is suggestive of hypoparathyroidism. The most common symptoms of hypoparathyroidism include tetany, paresthesia, carpopedal spasms, and circumoral numbness. Common symptoms of hypoparathyroidism include abdominal pain, biliary colic, fatigue, muscle cramps, myoclonic jerks, new onset seizure due to hypocalcemia or worsening of seizures, and painful menstruation. Less common symptoms of hypoparathyroidism include cognitive impairment, decreased concentration, hoarseness, neuromuscular irritability, palpitations, personality disturbances and/or mood changes, symptoms of acute cardiomyopathy, wheezing, and dyspnea.
History and Symptoms
History
Patients with hypoparathyroidism may have a positive history of:[1][2]
- History of neck surgery
- A family history of hypocalcemia and/or hypoparathyroidism
- A history of other autoimmune endocrinopathies (e.g., adrenal insufficiency)
- A history of candidiasis
- Immunodeficiency
Symptoms
- Clinical symptoms depends on two features:[3]
- Acuteness of hypocalcemia
- The absolute level of serum calcium
- Patients presents dramatically and tends to have more symptoms if there is an acute hypocalcemia compared to patients with chronic hypocalcemia.[4]
Common symptoms
Common symptoms of hypoparathyroidism include:[3][5]
- Tetany (hallmark of acute hypocalcemia)
- Paresthesia in fingertips, toes, perioral area
- Carpopedal spasms
- Circumoral numbness
- Abdominal pain
- Biliary colic
- Fatigue
- Muscle cramps
- Myoclonic jerks
- New onset seizure due to hypocalcemia or worsening of seizures
- Painful menstruation
Less common synptoms
Less common symptoms of hypoparathyroidism include:[3][5]
- Cognitive impairment
- Hoarseness (due to laryngospasm)
- Neuromuscular irritability
- Palpitations due cardiac dysarrhythmias
- Personality disturbances and/or mood changes
- Symptoms of acute cardiomyopathy
- Wheezing and dyspnea (due to bronchospasm)
- Electrocardiographic changes that mimic myocardial infarction, or congestive heart failure (decreased cardiac contractility is related to low serum calcium and possibly parathyroid hormone deficiency, as parathyroid hormone receptors are present in cardiac myocytes).[6]
References
- ↑ Brun JM (1982). "Juvenile autoimmune polyendocrinopathy". Horm. Res. 16 (5): 308–16. PMID 7173823.
- ↑ Shoback D (2008). "Clinical practice. Hypoparathyroidism". N. Engl. J. Med. 359 (4): 391–403. doi:10.1056/NEJMcp0803050. PMID 18650515.
- ↑ 3.0 3.1 3.2 Abate EG, Clarke BL (2016). "Review of Hypoparathyroidism". Front Endocrinol (Lausanne). 7: 172. doi:10.3389/fendo.2016.00172. PMC 5237638. PMID 28138323.
- ↑ Tohme JF, Bilezikian JP (1993). "Hypocalcemic emergencies". Endocrinol. Metab. Clin. North Am. 22 (2): 363–75. PMID 8325292.
- ↑ 5.0 5.1 Cooper MS, Gittoes NJ (2008). "Diagnosis and management of hypocalcaemia". BMJ. 336 (7656): 1298–302. doi:10.1136/bmj.39582.589433.BE. PMC 2413335. PMID 18535072.
- ↑ Kimura S, Yoshioka K (2014). "Parathyroid hormone and parathyroid hormone type-1 receptor accelerate myocyte differentiation". Sci Rep. 4: 5066. doi:10.1038/srep05066. PMC 4052750. PMID 24919035.