Management of Hypoparathyroidism: Summary Statement and Guidelines

Brandi, Maria Luisa; Bilezikian, John P.; Shoback, Dolores; Bouillon, Roger; Clarke, B.L.; Thakker, Rajesh V.; Khan, Aliya; Potts, John T.

doi:10.1210/jc.2015-3907

Cited by 335 publications

(461 citation statements)

References 81 publications

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“…The neuropsychiatric complications of the disease are not well recognized and are often underestimated. Nevertheless, at the First International Conference on "The Diagnosis, Management, and Treatment of Hypoparathyroidism" in 2015, researchers have emphasized the quality of life as one of the areas requiring additional research within the next 5 years (22). In fact, more evidence is necessary to determine the relation between these patients' wellbeing and their biochemical parameters, as well as their response to different treatments.…”

Section: Discussionmentioning

confidence: 99%

Self-report of psychological symptoms in hypoparathyroidism patients on conventional therapy

Arneiro¹,

Duarte²,

Kulchetscki³

et al. 2018

Archives of Endocrinology and Metabolism

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Objective: Hypoparathyroidism is characterized by parathyroid hormone deficiency and hypocalcemia. It has been demonstrated that these patients may also present psychiatric symptoms and decrease of quality of life. The aims of this study were to evaluate the presence of psychopathological symptoms in a cohort of patients with hypoparathyroidism and compare to a control group. Subjects and methods: Patients were submitted to a cross-sectional Symptom Checklist-90-R (SCL-90-R) questionnaire that evaluates psychopathological symptoms by means of the Global Severity Index (GSI), Positive Symptoms Total (PST) and Positive Symptom Distress Index (PSDI). A score based in the positive symptoms was calculated (T-score). The test group was composed of patients with hypoparathyroidism, and control by thyroidectomized patients without hypoparathyroidism. A correlation between the presence of psychological symptoms and clinical features was analyzed. Results: The study included 57 patients with a mean age of 51.1 ± 16.4 years; 20 as a control and 37, test group. There were no differences between groups regarding gender, mean age and age at diagnose. Hypoparathyroidism patients presented higher GSI index than the control group (p = 0.038). Mean T-score of the test group was as elevated as 58.2 ± 5.3 (reference range < 55). No correlation of the number of psychological symptoms to clinical and laboratorial parameters was observed. Conclusion: Patients with hypoparathyroidism attending our outpatient clinics presented an increase in the number of self-report of psychological symptoms when compared with a control group. However, no correlation with hypocalcemia and clinical parameters was observed. Future studies are necessary to evaluated if the absence of PTH play a role on it.

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Section: Discussionmentioning

confidence: 99%

Self-report of psychological symptoms in hypoparathyroidism patients on conventional therapy

Arneiro¹,

Duarte²,

Kulchetscki³

et al. 2018

Archives of Endocrinology and Metabolism

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“…These cases account for all the procedures of the neck region that resulted in impaired parathyroid function and involved a mean of 1.3/100,000 inhabitants per year during the observation. Overall, the prevalence of postsurgical hypoparathyroidism in previous reports varied according to centers of different expertise and experience [1][2][3][4][5][9][10][11][12][13][14]. The type and extension of surgery of the neck structures and, consequently, the underlying disease, as well as repeated surgeries, can also affect the rate of postoperative hypoparathyroidism [1,11,15].…”

Section: Discussionmentioning

confidence: 99%

The Epidemiology of Hypoparathyroidism in Italy: An 8-Year Register-Based Study

et al. 2016

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Hypoparathyroidism is a rare endocrine disorder, but few studies have focused on the epidemiology and hospital management of the disease and none has been performed in Italy. We investigated the prevalence of different forms of hypoparathyroidism among hospitalized patients in Italy during an 8-year period. This study is designed as a retrospective register-based study. We retrieved data from the ''Record of Hospital Discharge'' (SDO) of the Italian Health Ministry, from the year 2006 to 2013 and analyzed the codes corresponding to hypoparathyroidism-related diagnoses. The inpatient prevalence of the disease was also calculated after excluding repeated hospitalizations. Overall, 27,692 hospitalization episodes for hypoparathyroidism were identified during the entire period (72.2% in women and 27.8% in men; mean age 49.5 ± 22.9 years). The mean length of stay was 7.4 ± 9.8 days (25.9% of the episodes requiring less than 3 days of stay). The mean hospitalization rate for hypoparathyroidism was 5.9/100,000 inhabitants per year and there was a significant decrease during the period of 2006-2013 (p \ 0.0001). The mean hospitalization rate for postsurgical hypoparathyroidism was 1.4/100,000 inhabitants per year and the trend showed a significant reduction during the years (p \ 0.0001). The mean prevalence of hypoparathyroidism among inpatients was 5.3/100,000 inhabitants per year, and there was a significant decrease over the years (p \ 0.0001). Hypoparathyroidism, particularly the postsurgical form of the disease, is not an uncommon condition among hospitalized patients in Italy. We observed a tendency to a decrease in the frequency of hospitalization during the period 2006-2013.

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“…There is wide consensus (3)(4)(5) that the best replacement treatment for PH consists of calcium salts associated with active vitamin D analogues to maintain sCa concentrations between 2 mmol/L (8 mg/dL) and the lower limit of the reference avoiding hypocalcemic symptoms. No formal recommendations have been agreed regarding the most appropriate vitamin D analogue.…”

Section: Original Articlementioning

confidence: 99%

Clinical profile and long-term follow-up of 32 patients with postoperative permanent hypoparathyroidism

et al. 2017

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Background: Parathyroid failure is the most common complication after total thyroidectomy but permanent impairment of the parathyroid function is unusual. Limited data is available assessing long-term follow-up, quality of life and complications occurring in patients with permanent hypoparathyroidism (PH).We aimed to assess the incidence of complications derived from PH status, their influence on the quality of life perceived by PH patients and its relation to standard medical treatment with calcium salts and active vitamin D analogues.Methods: Cross-sectional observational study of consecutive patients undergoing total thyroidectomy who developed PH and were followed at least twice a year at a referral endocrine surgery unit. PH was defined as intact parathyroid hormone (iPTH) levels <13 pg/mL and the need for replacement therapy with calcium and/or vitamin D for at least 1 year after surgery. Quality of life was assessed using the SF-36 questionnaire.Data regarding doses and type of vitamin D analogues and calcium supplementation, serum calcium fluctuations, bone densitometry and renal ultrasound were recorded. Results:The cohort included 32 patients (3 male/29 female) with a mean age of 51.2±15.2 years. The mean follow-up was 78±68 months and the total follow-up length was 70,080 PH patient/days. Five (15.6%) patients showed a decreased renal function. At least one clinical adverse event was observed in 18 (56.3%)patients. There was a slight decrease of the punctuation in the SF-36 questionnaire for the perceived quality of life that was only significant for the emotional role.Conclusions: PH and its treatment carry a mild to moderate burden of illness if followed closely. During a mean follow-up of nearly 6 years, only half of the patients suffered a relevant clinical event with little impact on their quality of life.

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Management of Hypoparathyroidism: Summary Statement and Guidelines

Abstract: This document not only provides a summary of our current knowledge but also places recent advances in its management into a context that should enhance future advances in our understanding of hypoparathyroidism.

Cited by 335 publications

References 81 publications

Self-report of psychological symptoms in hypoparathyroidism patients on conventional therapy

Self-report of psychological symptoms in hypoparathyroidism patients on conventional therapy

The Epidemiology of Hypoparathyroidism in Italy: An 8-Year Register-Based Study

Clinical profile and long-term follow-up of 32 patients with postoperative permanent hypoparathyroidism

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