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Hypoparathyroidism, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Hypoparathyroidism occurs secondary to a deficiency in parathyroid hormone (PTH)

  • Pseudohypoparathyroidism occurs secondary to end-organ unresponsiveness to PTH

  • PTH:

    • Decreases urinary Ca...

Diagnosis

Signs and Symptoms

The most common symptomatic presentation is postoperatively after parathyroidectomy. 
Neonates/infants: 
  • Transient hypoparathyroidism in 1st yr of life

  • Below normal intelligen...

Treatment

Pre-Hospital

  • Administer calcium in refractory VFib or status epilepticus in addition to usual medications if known hypoparathyroidism or suspected hypocalcemia

  • Stridor may herald laryngospasm

Initial Stabilization/Therapy

Follow-Up

Disposition

Admission Criteria

  • Symptomatic hypocalcemia

  • Abnormal ECG

  • Inability to take vitamin D or calcium orally

  • Corrected calcium <5 mg/dL

Discharge Criteria

  • Asymptomatic hypocalcemia

  • Not meet...

Pearls and Pitfalls

  • Rapid onset of symptoms following surgical excision of the parathyroid glands is the most common symptomatic presentation

  • Symptoms often confused with hyperventilation or anxiety

  • In ...

Additional Reading

  • Al-Azem  H, Khan  AA. Hypoparathyroidism. Best Pract Res Clin Endocrinol Metab.  2012;26:517–522.

  • Andreoli  T, Carpenter  C. Cecil Essentials of Medicine. 7th ed. Philadelphia,...

Codes

ICD9

  • 252.1 Hypoparathyroidism

  • 275.49 Other disorders of calcium metabolism

  • 279.11 Digeorge's syndrome

  • 775.4 Hypocalcemia and hypomagnesemia of newborn

ICD10

  • E20.1 Pseudohypoparathyroidism

  • E20.9 Hypopar...

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