Hypoparathyroidism history and symptoms
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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.