Pediatric Hypoparathyroidism Follow-up

Updated: Aug 07, 2018
  • Author: Pisit (Duke) Pitukcheewanont, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Follow-up

Further Outpatient Care

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  • 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.

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Inpatient & Outpatient Medications

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  • 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.

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Complications

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  • Nephrocalcinosis

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

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Prognosis

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  • 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.

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Patient Education

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  • 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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