Hypoparathyroidism in Emergency Medicine Workup

Updated: Jan 07, 2022
  • Author: Andrew G Park, DO, MPH, FAWM; Chief Editor: Erik D Schraga, MD  more...
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Workup

Laboratory Studies

The diagnosis of hypoparathyroidism is supported by hypocalcemia, hyperphosphatemia, and low parathyroid hormone levels in the absence of renal failure or intestinal malabsorption.

Both total and ionized calcium are decreased. Normal total serum calcium levels range from 9 to 10.5 mg/dL (2.2-2.6 mmol/L). Normal ionized calcium levels are 4.5-5.6 mg/dL (1.1-1.4 mmol/L).

Serum magnesium level can be low, high, or normal.

Transient symptomatic hypocalcemia can occur immediately after thyroid surgery; normal parathyroid levels 3 hours after surgery and a normal serum calcium level on the postoperative day one rules out persistent hypoparathyroidism. [41]

For D-xylose absorption test, the results are usually normal. [42]

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Imaging Studies

Electrocardiography (ECG)

ECG may show prolonged QT interval, [43] bradycardia or, rarely, ST-segment elevations. [32]

Radiography

Bone density is increased [44] ; tooth enamel and root abnormalities have been described. [24] Ossification of the paravertebral ligaments is frequently observed. [27]

Computed tomography scanning

Calcification of subcortical nuclei, dentate nucleus, [21] and basal ganglia [22] can occur.

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Other Tests

 

 

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