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Hypoparathyroidism

Cherry Onaiwu, MD, MS, Luay Sarsam, MD and Carrie Valenta, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Deficient or absent secretion of parathyroid hormone (PTH), a major hormone regulator of serum calcium and phosphorus levels in the body (1)

  • Often asymptomatic

  • Acute hypoparathyroidism...

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/...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Goal is a total corrected serum calcium level in low normal range (8 to 8.5 mg/dL or 2 to 2.12 mmol/L), 24-hour urine calcium <300 mg, and ca...

REFERENCES

1
Abate E, Clark B. Review of hypoparathyroidism. Front Endocrinol (Lausanne).  2017;7:172. [View Abstract on OvidMedline]
2
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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