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.

Questions

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Powers J, Joy K, Ruscio A, Lagast H. Prevalence and incidence of hypoparathyroidism in the United States using a large claims database. J Bone Miner Res. 2013 Dec. 28 (12):2570-6. [QxMD MEDLINE Link]. [Full Text].
Cipriani C, Pepe J, Biamonte F, et al. The Epidemiology of Hypoparathyroidism in Italy: An 8-Year Register-Based Study. Calcif Tissue Int. 2017 Mar. 100 (3):278-285. [QxMD MEDLINE Link].
Bhadada SK, Bhansali A, Upreti V, Subbiah S, Khandelwal N. Spectrum of neurological manifestations of idiopathic hypoparathyroidism and pseudohypoparathyroidism. Neurol India. 2011 Jul-Aug. 59(4):586-9. [QxMD MEDLINE Link].
Rubin MR, Dempster DW, Zhou H, et al. Dynamic and structural properties of the skeleton in hypoparathyroidism. J Bone Miner Res. 2008 Dec. 23(12):2018-24. [QxMD MEDLINE Link]. [Full Text].
Orloff LA, Wiseman SM, Bernet VJ, et al. American Thyroid Association Statement on Postoperative Hypoparathyroidism: Diagnosis, Prevention, and Management in Adults. Thyroid. 2018 Jul. 28 (7):830-41. [QxMD MEDLINE Link].
Dinc T, Kayilioglu SI, Simsek B, et al. The evaluation of the complications observed in patients with bilateral total and bilateral near total thyroidectomy. Ann Ital Chir. 2017 Feb 24. 6:[QxMD MEDLINE Link].
Loncar I, Dulfer RR, Massolt ET, et al. Postoperative parathyroid hormone levels as a predictor for persistent hypoparathyroidism. Eur J Endocrinol. 2020 Aug. 183 (2):149-59. [QxMD MEDLINE Link].
Brown EM. Anti-parathyroid and anti-calcium sensing receptor antibodies in autoimmune hypoparathyroidism. Endocrinol Metab Clin North Am. 2009 Jun. 38(2):437-45, x. [QxMD MEDLINE Link]. [Full Text].
Goltzman D, Cole DEC. Hypoparathyroidism. Favus MJ, ed. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. Philadelphia, Pa: Lippincott-Raven; 1996. 220-3.
Mannstadt M, Clarke BL, Vokes T, Brandi ML, Ranganath L, Fraser WD, et al. Efficacy and safety of recombinant human parathyroid hormone (1-84) in hypoparathyroidism (REPLACE): a double-blind, placebo-controlled, randomised, phase 3 study. Lancet Diabetes Endocrinol. 2013 Dec. 1(4):275-83. [QxMD MEDLINE Link].
Rubin MR, Cusano NE, Fan WW, et al. Therapy of Hypoparathyroidism With PTH(1-84): A Prospective Six Year Investigation of Efficacy and Safety. J Clin Endocrinol Metab. 2016 Jul. 101 (7):2742-50. [QxMD MEDLINE Link].
Rejnmark L, Ayodele O, Lax A, Mu F, Swallow E, Gosmanova EO. The risk of chronic kidney disease development in adult patients with chronic hypoparathyroidism treated with rhPTH(1-84): A retrospective cohort study. Clin Endocrinol (Oxf). 2022 Aug 16. [QxMD MEDLINE Link]. [Full Text].
Bollerslev J, Rejnmark L, Marcocci C, Shoback DM, Sitges-Serra A, van Biesen W, et al. European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol. 2015 Aug. 173 (2):G1-G20. [QxMD MEDLINE Link].
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Author

Joseph Michael Gonzalez-Campoy, MD, PhD, FACE Medical Director and CEO, Minnesota Center for Obesity, Metabolism, and Endocrinology

Joseph Michael Gonzalez-Campoy, MD, PhD, FACE is a member of the following medical societies: American Association of Clinical Endocrinologists, Association of Clinical Researchers and Educators, Minnesota Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

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 and Translational Research, Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD Professor Emeritus of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for Physician Leadership, American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society, International Society for Clinical Densitometry, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.