Hypoparathyroidism
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- Hypoparathyroidism is a rare disease that results in hypocalcemia. Symptoms, when present, range from paresthesias and muscle cramps to seizures and laryngospasm.
- The most common cause is injury to or removal of the parathyroid gland during anterior neck surgery. Other genetic or autoimmune causes may be isolated or part of a larger syndrome.
- Hypoparathyroidism is often associated with basal ganglia calcification, cataracts, and neuropsychiatric symptoms.
- The goal of treatment is to maintain the blood calcium level near the low end of the normal range while preventing symptoms of hypocalcemia; this is usually achieved with oral calcium and active vitamin D (calcitriol or alfacalcidol) supplementation but may involve treatment with subcutaneous parathyroid hormone therapy.
- Treatment is commonly associated with hypercalciuria, nephrocalcinosis, nephrolithiasis, and renal insufficiency, thus emphasizing the need for careful monitoring and improved therapies. 소스;NEJM 5/8/1029