Hypoparathyroidism in Emergency Medicine Follow-up

  • Author: Agnieszka Gliwa, MD; Chief Editor: Erik D Schraga, MD   more...
 
Updated: Mar 21, 2012
 

Further Inpatient Care

  • Effects of 1 bolus of intravenous calcium will wane after 2 hours; therefore, subsequent continuous infusion is required to control hypocalcemia.
  • Cardiac monitoring is indicated for patients with hypoparathyroidism.
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Further Outpatient Care

  • High-calcium diet
  • Calcium supplementation
  • Calcitriol
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Complications

Complications of hypoparathyroidism may include the following:

  • Neuromuscular symptoms
  • Cataracts[22]
  • Intracranial calcifications[39, 40]
  • Growth stunting (with HDR syndrome)[45]
  • Tooth malformation[37]
  • Mental retardation (with HDR syndrome)[45]
  • Hypothyroidism
  • Cardiomyopathy[43]
  • Parkinsonian symptoms[46]
  • Ossification of paravertebral ligaments[38]
  • Adhesive capsulitis[47]
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Prognosis

  • Prognosis is determined by the underlying cause of hypoparathyroidism.
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Patient Education

  • Educate patients concerning regulation and effects of calcium on the body.
  • Educate patients about the importance of periodic blood chemistry evaluation.
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Contributor Information and Disclosures
Author

Agnieszka Gliwa, MD  Assistant Professor of Medicine, State University of New York Downstate Medical Center College of Medicine, Brooklyn; Attending Physician and Endocrinologist, Staten Island University Hospital

Agnieszka Gliwa, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians-American Society of Internal Medicine, American Medical Association, and Endocrine Society

Disclosure: Nothing to disclose.

Coauthor(s)

David J Wallace, MD, MPH  Critical Care Medicine Fellow, University of Pittsburgh Medical Center

David J Wallace, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Erik D Schraga, MD  Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Howard A Bessen, MD  Professor of Medicine, Department of Emergency Medicine, University of California, Los Angeles, David Geffen School of Medicine; Program Director, Harbor-UCLA Medical Center

Howard A Bessen, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Erik D Schraga, MD  Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

References

  1. Shoback D. Clinical practice. Hypoparathyroidism. N Engl J Med. Jul 24 2008;359(4):391-403. [Medline].

  2. Chandran M, Deftos LJ, Stuenkel CA, Haghighi P, Orloff LA. Thymic parathyroid carcinoma and postoperative hungry bone syndrome. Endocr Pract. Mar-Apr 2003;9(2):152-6. [Medline].

  3. Maeda SS, Fortes EM, Oliveira UM, Borba VC, Lazaretti-Castro M. Hypoparathyroidism and pseudohypoparathyroidism. Arq Bras Endocrinol Metabol. Aug 2006;50(4):664-73. [Medline].

  4. Pieringer H, Hatzl-Griesenhofer M, Shebl O, Wiesinger-Eidenberger G, Maschek W, Biesenbach G. Hypocalcemic tetany in the newborn as a manifestation of unrecognized maternal primary hyperparathyroidism. Wien Klin Wochenschr. 2007;119(3-4):129-31. [Medline].

  5. Poomthavorn P, Ongphiphadhanakul B, Mahachoklertwattana P. Transient neonatal hypoparathyroidism in two siblings unmasking maternal normocalcemic hyperparathyroidism. Eur J Pediatr. Apr 2008;167(4):431-4. [Medline].

  6. Ip P. Neonatal convulsion revealing maternal hyperparathyroidism: an unusual case of late neonatal hypoparathyroidism. Arch Gynecol Obstet. Aug 2003;268(3):227-9. [Medline].

  7. Graber ML. Magnesium deficiency: pathophysiologic and clinical overview. Am J Kidney Dis. Jun 1995;25(6):973. [Medline].

  8. Kitsiou-Tzeli S, Kolialexi A, Mavrou A. Endocrine manifestations in DiGeorge and other microdeletion syndromes related to 22q11.2. Hormones (Athens). Oct-Dec 2005;4(4):200-9. [Medline].

  9. Courtens W, Wuyts W, Poot M, Szuhai K, Wauters J, Reyniers E, et al. Hypoparathyroidism-retardation-dysmorphism syndrome in a girl: A new variant not caused by a TBCE mutation--clinical report and review. Am J Med Genet A. Mar 15 2006;140(6):611-7. [Medline].

  10. Carpenter TO, Carnes DL Jr, Anast CS. Hypoparathyroidism in Wilson's disease. N Engl J Med. Oct 13 1983;309(15):873-7. [Medline].

  11. Brinkane A, Peschard S, Leroy-Terquem E, Bergheul S, Raheriarisoa H, Hubert N, et al. [Rare association of hypoparathyroidism and mediastinal-pulmonary sarcoidosis]. Ann Med Interne (Paris). Feb 2001;152(1):63-4. [Medline].

  12. Kashyap AS, Padmaprakash KV, Kashyap S, Anand KP. Acute laryngeal spasm. Emerg Med J. Jan 2007;24(1):66. [Medline].

  13. Langevitz P, Fichman B, Cabili S. Recurrent laryngospasm: a neglected symptom of hypoparathyroidism. South Med J. Nov 1985;78(11):1400. [Medline].

  14. Lehmann G, Deisenhofer I, Ndrepepa G, Schmitt C. ECG changes in a 25-year-old woman with hypocalcemia due to hypoparathyroidism. Hypocalcemia mimicking acute myocardial infarction. Chest. Jul 2000;118(1):260-2. [Medline].

  15. Ratanaanekchai T, Art-smart T, Vatanasapt P. Dysphagia after total laryngectomy resulting from hypocalcemia: case report. J Med Assoc Thai. Jun 2004;87(6):722-4. [Medline].

  16. Fuleihan Gel-H, Rubeiz N. Dermatologic manifestations of parathyroid-related disorders. Clin Dermatol. Jul-Aug 2006;24(4):281-8. [Medline].

  17. Kazmi AS, Wall BM. Reversible congestive heart failure related to profound hypocalcemia secondary to hypoparathyroidism. Am J Med Sci. Apr 2007;333(4):226-9. [Medline].

  18. Gupta RP, Krishnan RA, Kumar S, Beniwal S, Devaraja R, Kochar SK. A rare cause of heart failure--primary hypoparathyroidism. J Assoc Physicians India. Jul 2007;55:522-4. [Medline].

  19. Mavroudis K, Aloumanis K, Stamatis P, Antonakoudis G, Kifnidis K, Antonakoudis C. Irreversible end-stage heart failure in a young patient due to severe chronic hypocalcemia associated with primary hypoparathyroidism and celiac disease. Clin Cardiol. Feb 2010;33(2):E72-5. [Medline].

  20. Walton DM, Thomas DC, Aly HZ, Short BL. Morbid hypocalcemia associated with phosphate enema in a six-week-old infant. Pediatrics. Sep 2000;106(3):E37. [Medline].

  21. Ulozas E, Chebrolu SB, Shanaah A, Daoud TM, Leehey DJ, Ing TS. Symptomatic hypocalcemia due to the inadvertent use of a calcium-free hemodialysate. Artif Organs. Feb 2004;28(2):229-31. [Medline].

  22. Rajendram R, Deane JA, Barnes M, Swift PG, Adamson K, Pearce S, et al. Rapid onset childhood cataracts leading to the diagnosis of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. Am J Ophthalmol. Nov 2003;136(5):951-2. [Medline].

  23. Goswami R, Mohapatra T, Gupta N, Rani R, Tomar N, Dikshit A, et al. Parathyroid hormone gene polymorphism and sporadic idiopathic hypoparathyroidism. J Clin Endocrinol Metab. Oct 2004;89(10):4840-5. [Medline].

  24. Goswami R, Brown EM, Kochupillai N, Gupta N, Rani R, Kifor O, et al. Prevalence of calcium sensing receptor autoantibodies in patients with sporadic idiopathic hypoparathyroidism. Eur J Endocrinol. Jan 2004;150(1):9-18. [Medline].

  25. D'Souza-Li L. The calcium-sensing receptor and related diseases. Arq Bras Endocrinol Metabol. Aug 2006;50(4):628-39. [Medline].

  26. Mune T, Yasuda K, Ishii M, Matsunaga T, Miura K. Tetany due to hypomagnesemia induced by cisplatin and doxorubicin treatment for synovial sarcoma. Intern Med. May 1993;32(5):434-7. [Medline].

  27. Al-Elq AH, Al-Saeed HH. Endocrinopathies in patients with thalassemias. Saudi Med J. Oct 2004;25(10):1347-51. [Medline].

  28. Reyes HM, Wright JK, Rosenfield RL. Prevention of hypocalcemia in children due to parathyroid infarction after thyroidectomy. Surg Gynecol Obstet. Jan 1979;148(1):76-8. [Medline].

  29. Navarro JF, Mora C, Jimenez A, Torres A, Macia M, Garcia J. Relationship between serum magnesium and parathyroid hormone levels in hemodialysis patients. Am J Kidney Dis. Jul 1999;34(1):43-8. [Medline].

  30. Cann CE, Prussin SG, Gordan GS. Aluminum uptake by the parathyroid glands. J Clin Endocrinol Metab. Oct 1979;49(4):543-5. [Medline].

  31. Keating MJ, Sethi MR, Bodey GP, Samaan NA. Hypocalcemia with hypoparathyroidism and renal tubular dysfunction associated with aminoglycoside therapy. Cancer. Apr 1977;39(4):1410-4. [Medline].

  32. Fiore CE, Lunetta M, Kanis JA. Long-term effects of histamine H2-receptor antagonists on serum parathyroid hormone in chronic renal failure. Clin Endocrinol (Oxf). Sep 1985;23(3):277-82. [Medline].

  33. Kashyap AS, Kashyap S. Hypoparathyroidism unmasked by alendronate. Postgrad Med J. Jul 2000;76(897):417-8. [Medline].

  34. Francois M, Levy-Bohbot N, Caron J, Durlach V. [Chronic use of proton-pump inhibitors associated with giardiasis: A rare cause of hypomagnesemic hypoparathyroidism?]. Ann Endocrinol (Paris). Nov 2008;69(5):446-8. [Medline].

  35. Hermann M, Ott J, Promberger R, Kober F, Karik M, Freissmuth M. Kinetics of serum parathyroid hormone during and after thyroid surgery. Br J Surg. Dec 2008;95(12):1480-7. [Medline].

  36. Laway BA, Goswami R, Singh N, Gupta N, Seith A. Pattern of bone mineral density in patients with sporadic idiopathic hypoparathyroidism. Clin Endocrinol (Oxf). Apr 2006;64(4):405-9. [Medline].

  37. Klingberg G, Dietz W, Oskarsdottir S, Odelius H, Gelander L, Noren JG. Morphological appearance and chemical composition of enamel in primary teeth from patients with 22q11 deletion syndrome. Eur J Oral Sci. Aug 2005;113(4):303-11. [Medline].

  38. Okazaki T, Takuwa Y, Yamamoto M, Matsumoto T, Igarashi T, Kurokawa T, et al. Ossification of the paravertebral ligaments: a frequent complication of hypoparathyroidism. Metabolism. Aug 1984;33(8):710-3. [Medline].

  39. Abe S, Tojo K, Ichida K, Shigematsu T, Hasegawa T, Morita M, et al. A rare case of idiopathic hypoparathyroidism with varied neurological manifestations. Intern Med. Feb 1996;35(2):129-34. [Medline].

  40. Chow KS, Lu DN. [Primary hypoparathyroidism with basal ganglia calcification: report of a case]. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. Mar-Apr 1989;30(2):129-33. [Medline].

  41. Mangat JS, Till J, Bridges N. Hypocalcaemia mimicking long QT syndrome: case report. Eur J Pediatr. Feb 2008;167(2):233-5. [Medline].

  42. Hayashida CY, Toledo SP, Barros MT, Ezabella MC, Laudanna AA. [Polyglandular autoimmune type I syndrome with hypoparathyroidism, chronic mucocutaneous candidiasis and intestinal malabsorption]. Rev Hosp Clin Fac Med Sao Paulo. Jan-Feb 1990;45(1):24-8. [Medline].

  43. Lam E J, Maragano L P, Lepez Q B, Vasquez N L. [Hypocalcemic cardiomyopathy secondary to hypoparathyroidism after a thyroidectomy: Report of one case.]. Rev Med Chil. Mar 2007;135(3):359-64. Epub 2007 Apr 26. [Medline].

  44. Teaema FH, Al Ansari K. Nineteen cases of symptomatic neonatal hypocalcemia secondary to vitamin D deficiency: a 2-year study. J Trop Pediatr. Apr 2010;56(2):108-10. [Medline].

  45. Hershkovitz E, Rozin I, Limony Y, Golan H, Hadad N, Gorodischer R, et al. Hypoparathyroidism, retardation, and dysmorphism syndrome: impaired early growth and increased susceptibility to severe infections due to hyposplenism and impaired polymorphonuclear cell functions. Pediatr Res. Oct 2007;62(4):505-9. [Medline].

  46. Tambyah PA, Ong BK, Lee KO. Reversible parkinsonism and asymptomatic hypocalcemia with basal ganglia calcification from hypoparathyroidism 26 years after thyroid surgery. Am J Med. Apr 1993;94(4):444-5. [Medline].

  47. Harzy T, Benbouazza K, Amine B, Rahmouni R, Guedira N, Hajjaj-Hassouni N. Idiopathic hypoparathyroidism and adhesive capsulitis of the shoulder in two first-degree relatives. Joint Bone Spine. May 2004;71(3):234-6. [Medline].

 
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