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Medical and Surgical Treatment of Parathyroid Diseases pp 115–127Cite as

Hypoparathyroidism

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Abstract

Hypoparathyroidism is a rare disorder that may be acquired or inherited. The most common acquired form is postsurgical hypoparathyroidism. The incidence of transient postsurgical hypoparathyroidism is fairly common at 25.4–83 %, whereas the incidence of permanent postsurgical hypoparathyroidism is much lower at 0.12–4.6 %. The prevalence of postsurgical and nonsurgical hypoparathyroidism in the U.S. is estimated to be about 37 per 100,000 person-years, whereas the prevalence of postsurgical hypoparathyroidism in Denmark is estimated at 22 per 100,000 person-years.

The severity of the condition is variable, with most patients mildly to moderately affected, and a few severely affected. Severely affected patients may die due to complications of their hypocalcemia. Patients with hypoparathyroidism experience a range of complications including hypocalcemia, hypercalcemia, and hypercalciuria due to treatment, as well as comorbidities including renal insufficiency, kidney stones, neuropsychiatric disease, infections, seizures, cataracts, skeletal disease, and basal ganglia and other intracerebral calcifications.

Treatment of acute hypoparathyroidism involves giving a bolus of intravenous calcium gluconate, followed by a slower infusion of calcium gluconate, and eventual transition to oral calcium carbonate or citrate, and vitamin D supplementation. Current treatment of chronic hypoparathyroidism is based on high-dose oral calcium, vitamin D supplementation in the form of calcitriol due to its rapid onset and offset of action, magnesium supplementation as required, and thiazide-type diuretics as needed. Parathyroid hormone (PTH) 1-84 is approved in the U.S. as adjunctive therapy when calcium and calcitriol therapy are not sufficient to achieve the target low-normal or mildly decreased serum calcium range.

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  1. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Internal Medicine, Mayo Clinic College of Medicine, Mayo Clinic East 18-A, 200 First Street SW, Rochester, MN, 55905, USA

    Bart L. Clarke M.D.

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  1. Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Brendan C. Stack, Jr.

  2. Department of Geniatrics and Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Donald L. Bodenner

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Clarke, B.L. (2017). Hypoparathyroidism. In: Stack, Jr., B., Bodenner, D. (eds) Medical and Surgical Treatment of Parathyroid Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-26794-4_11

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