Hypoparathyroidism

Cherry Onaiwu, MD, MS, Luay Sarsam, MD and Carrie Valenta, MD, FACP, FHM Reviewed 06/2019

BASICS

DESCRIPTION

Deficient or absent secretion of parathyroid hormone (PTH), a major hormone regulator of serum calcium and phosphorus levels in the body (1)
Acute hypoparathyroidism: tetany that is m...

DIAGNOSIS

HISTORY

Often asymptomatic; ask about previous neck trauma or surgery, head or neck irradiation, family history of hypocalcemia, or presence of other autoimmune endocrinopathies.

Cardinal cli...

TREATMENT

GENERAL MEASURES

Monitor ECG during calcium repletion.
Maintenance therapy: may require lifelong treatment with calcium and calcitriol
- Maintain serum calcium in low normal range: 8 to 8.5 mg/dL...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Goal is a total corrected serum calcium level in low normal range (8.0 to 8.5 mg/dL or 2.00 to 2.12 mmol/L), 24-hour urine calcium <300 mg, a...

REFERENCES

Abate E, Clarke B. Review of hypoparathyroidism. Front Endocrinol (Lausanne). 2017;7:172. [View Abstract on OvidMedline]

Al-Azem H, Khan A. Hypoparathyroidism. Best Pract Res Clin En...

ADDITIONAL READING

Bollerslev J, Rejnmark L, Marcocci C, et al. European Society of Endocrinology clinical guideline: treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol. 2015;17...

CODES

ICD10

E20.9 Hypoparathyroidism, unspecified
P71.4 Transitory neonatal hypoparathyroidism
E89.2 Postprocedural hypoparathyroidism
E20.1 Pseudohypoparathyroidism
E20.0 Idiopathic hypoparathyroidism
E20....

CLINICAL PEARLS

Often asymptomatic; consider if hypocalcemic with fatigue and circumoral or distal extremity paresthesias.

Correct the serum calcium level for albumin level.
Monitor calcium after thyro...

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