Further Outpatient Care

See the list below:

Close follow-up of serum calcium concentrations is required in the first months of hypoparathyroidism treatment; after the serum calcium and phosphate levels stabilize, monitor these serum data every 3-6 months. Urine calcium/creatinine ratio should be monitored as well for hypercalciuria. Therapeutic goal is to maintain serum calcium in the low-normal range to decrease risk for nephrocalcinosis.
Renal ultrasonographic studies are needed annually to assess for nephrocalcinosis development.

Inpatient & Outpatient Medications

See the list below:

1,25-Dihydroxyvitamin D: This medication bypasses the parathyroid hormone (PTH)-dependent step of 1-alpha hydroxylation of 25 hydroxyvitamin D. It should be used in combination with a calcium supplement to maintain the calcium in the low normal range and serum phosphate concentrations in the mid range.
Calcium: Any of the oral calcium supplements may be used.

Complications

See the list below:

Nephrocalcinosis
Hypocalcemia-related events, including tetany, seizure, laryngospasm, arrhythmia, and syncope

Prognosis

See the list below:

Hypoparathyroidism is a chronic disease requiring strict compliance with medications. As with any chronic illness, compliance can be difficult to achieve with adolescents.
Nephrocalcinosis can lead to kidney damage requiring intervention.

Patient Education

See the list below:

Family members should recognize the signs of hypocalcemia.
During times of stress, such as surgery or significant intercurrent illness, inherited disorders of hypoparathyroidism that have seemingly resolved can be unmasked and require intervention.

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Media Gallery

Electrocardiogram (ECG) findings in severe hypocalcemia.

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Author

Pisit (Duke) Pitukcheewanont, MD Associate Professor of Clinical Pediatrics, University of Southern California, Keck School of Medicine, Childrens Hospital Los Angeles

Pisit (Duke) Pitukcheewanont, MD is a member of the following medical societies: American Academy of Pediatrics, American Diabetes Association, American Medical Association, American Society for Bone and Mineral Research, Endocrine Society, Pediatric Endocrine Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London) Professor and Chair, First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, Greece; UNESCO Chair on Adolescent Health Care, University of Athens, Greece

George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London) is a member of the following medical societies: American Academy of Pediatrics, American College of Physicians, American Pediatric Society, American Society for Clinical Investigation, Association of American Physicians, Endocrine Society, Pediatric Endocrine Society, Society for Pediatric Research, American College of Endocrinology

Disclosure: Nothing to disclose.

Chief Editor

Sasigarn A Bowden, MD, FAAP Professor of Pediatrics, Section of Pediatric Endocrinology, Metabolism and Diabetes, Department of Pediatrics, Ohio State University College of Medicine; Pediatric Endocrinologist, Division of Endocrinology, Nationwide Children’s Hospital; Affiliate Faculty/Principal Investigator, Center for Clinical Translational Research, Research Institute at Nationwide Children’s Hospital

Sasigarn A Bowden, MD, FAAP is a member of the following medical societies: American Society for Bone and Mineral Research, Central Ohio Pediatric Society, Endocrine Society, International Society for Pediatric and Adolescent Diabetes, Pediatric Endocrine Society, Society for Pediatric Research

Disclosure: Nothing to disclose.

Additional Contributors

Thomas A Wilson, MD Professor of Clinical Pediatrics, Chief and Program Director, Division of Pediatric Endocrinology, Department of Pediatrics, The School of Medicine at Stony Brook University Medical Center

Thomas A Wilson, MD is a member of the following medical societies: Endocrine Society, Pediatric Endocrine Society, Phi Beta Kappa

Disclosure: Nothing to disclose.

Sections Pediatric Hypoparathyroidism
Overview
Presentation
- History
- Physical
- Causes
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DDx
Workup
Treatment
Medication
Follow-up
References

Pediatric Hypoparathyroidism Follow-up

Further Outpatient Care

Inpatient & Outpatient Medications

Complications

Prognosis

Patient Education

References

Tables

Contributor Information and Disclosures

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