Hypoparathyroidism screening

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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

There is insufficient evidence to recommend routine screening for hypoparathyroidism. However, a significant number of patients of isolated idiopathic hypoparathyroidism with hypercaliuria may have a de novo calcium-sensing receptor (CASR) gene mutation. Molecular screening of CASR gene in patients with this presentation is recommended during initial work-up as it has potentially important clinical relevance to the patient’s prognosis.

Screening

  • There is insufficient evidence to recommend routine screening for hypoparathyroidism.
  • However, a significant number of patients of isolated idiopathic hypoparathyroidism with hypercalciuria may have a de novo calcium-sensing receptor (CASR) gene mutation.
  • All patients require treatment with 1-hydroxylated vitamin D3 for correction of hypocalcemia.
  • As 1-hydroxylated vitamin D3 may precipitate prolonged episode of hypercalciuria, the treatment decision should be evaluated on an individual basis in asymptomatic or mildly symptomatic patients.
  • Molecular screening of CASR gene in patients with isolated idiopathic hypoparathyroidism with hypercaliuria is recommended during initial work-up as it has potentially important clinical relevance to the patient’s prognosis.[1]

References

  1. Lienhardt A, Bai M, Lagarde JP, Rigaud M, Zhang Z, Jiang Y, Kottler ML, Brown EM, Garabédian M (2001). "Activating mutations of the calcium-sensing receptor: management of hypocalcemia". J. Clin. Endocrinol. Metab. 86 (11): 5313–23. doi:10.1210/jcem.86.11.8016. PMID 11701698.

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