eMedicine Specialties > Endocrinology > Parathyroid Gland

Hypoparathyroidism: Follow-up

Author: J Michael Gonzalez-Campoy, MD, PhD, FACE, Medical Director and CEO, MN Center for Obesity, Metabolism, and Endocrinology
Contributor Information and Disclosures

Updated: Jul 17, 2009

Follow-up

Further Outpatient Care

  • Patients with primary hypoparathyroidism have a lifelong risk of symptomatic tetany.
  • Without access to calcium, a patient may die.
  • All patients should wear a chain or bracelet that identifies them as having primary hypoparathyroidism.

Complications

  • Nephrocalcinosis
  • Nephrolithiasis

Patient Education

  • Diuretic use: The use of any diuretic medication may alter calcium homeostasis. Patients must know this and should remind their practitioner whenever new medications are prescribed.
  • Pregnancy: Medications that alter the synthesis of proteins and albumin in the liver and/or hyperestrogenic states, such as pregnancy, may lead to alterations in calcium homeostasis. Instruct patients to consult their doctor prior to any changes in any medications.

Miscellaneous

Medicolegal Pitfalls

  • In discussing the risks of untreated primary hypoparathyroidism with patients, document the signs and symptoms of severe hypocalcemia.
  • Direct patients to the emergency department for treatment if mental status changes or respiratory distress develops.
  • Recommend that patients wear a chain or bracelet identifying them as having primary hypoparathyroidism; document this recommendation in the chart.
 


More on Hypoparathyroidism

Overview: Hypoparathyroidism
Differential Diagnoses & Workup: Hypoparathyroidism
Treatment & Medication: Hypoparathyroidism
Follow-up: Hypoparathyroidism
References
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References

  1. Goswami R, Goel S, Tomar N, et al. Prevalence of clinical remission in patients with sporadic idiopathic hypoparathyroidism. Clin Endocrinol (Oxf). Jun 22 2009;[Medline].

  2. Rubin MR, Dempster DW, Zhou H, et al. Dynamic and structural properties of the skeleton in hypoparathyroidism. J Bone Miner Res. Dec 2008;23(12):2018-24. [Medline].

  3. Ebrahimi H, Edhouse P, Lundgren CI, et al. Does autoimmune thyroid disease affect parathyroid autotransplantation and survival?. ANZ J Surg. May 2009;79(5):383-5. [Medline].

  4. Brown EM. Anti-parathyroid and anti-calcium sensing receptor antibodies in autoimmune hypoparathyroidism. Endocrinol Metab Clin North Am. Jun 2009;38(2):437-45, x. [Medline].

  5. Goltzman D, Cole DEC. Hypoparathyroidism. In: Favus MJ, ed. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. Philadelphia, Pa: Lippincott-Raven; 1996:220-3.

  6. Cheung M. Drugs used in paediatric bone and calcium disorders. Endocr Dev. 2009;16:218-232. [Medline].

  7. Brown EM, Harris HW, Vassilev PM. The biology of the extracellular Ca2+-sensing receptor. In: Bilezikian JP, ed. Principles of Bone Biology. San Diego, Calif: Academic Press; 1996:243-62.

  8. Cole DEC, Hendy GN. Hypoparathyroidism and pseudohypoparathyroidism. Endotext.com. 2005, Available at. [Full Text].

  9. Marx SJ. Hyperparathyroid and hypoparathyroid disorders. N Engl J Med. Dec 21 2000;343(25):1863-75. [Medline].

  10. Thakker RV. Molecular basis of PTH underexpression. In: Bilezikian JP, et al, eds. Principles of Bone Biology. San Diego, Calif: Academic Press; 1996:837-51.

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Further Reading

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Keywords

hypoparathyroidism, parathyroid, PTH, hyperparathyroidism, hypocalcemia, parathyroid hormone, tetany, parathyroid glands, parathyroid gland, surgery parathyroid, parathyroid surgery, parathyroidectomy, hypoparathyroid, parathyroid hormone deficiency, PTH deficiency, primary hypoparathyroidism, inadequate PTH activity, secondary hypoparathyroidism, hypercalcemia

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Contributor Information and Disclosures

Author

J Michael Gonzalez-Campoy, MD, PhD, FACE, Medical Director and CEO, MN Center for Obesity, Metabolism, and Endocrinology
J Michael Gonzalez-Campoy, MD, PhD, FACE is a member of the following medical societies: American Association of Clinical Endocrinologists, American Medical Association, and Minnesota Medical Association
Disclosure: Nothing to disclose.

Medical Editor

David S Schade, MD, Chief, Division of Endocrinology and Metabolism, Professor, Department of Internal Medicine, University of New Mexico School of Medicine and Health Sciences Center
David S Schade, MD is a member of the following medical societies: American College of Physicians, American Diabetes Association, American Federation for Medical Research, Endocrine Society, New Mexico Medical Society, New York Academy of Sciences, and Society for Experimental Biology and Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Yoram Shenker, MD, Chief of Endocrinology Section, Veterans Affairs Medical Center of Madison; Interim Chief, Associate Professor, Department of Internal Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Wisconsin at Madison
Yoram Shenker, MD is a member of the following medical societies: American Heart Association, Central Society for Clinical Research, and Endocrine Society
Disclosure: Nothing to disclose.

CME Editor

Mark Cooper, MBBS, PhD, FRACP, Head, Diabetes & Metabolism Division, Baker Heart Research Institute, Professor of Medicine, Monash University
Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD, Professor of Medicine, St Louis University School of Medicine
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.

 
 
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