Vnitr Lek 2024, 70(1):22-27 | DOI: 10.36290/vnl.2024.004

Clinical manifestations of chronic hypoparathyroidism

Roman Králik, Martin Kužma, Juraj Payer

V. interná klinika UNB a LFUK Bratislava

Hypoparathyroidism is a rare disease, which is unique among endocrine diseases because of the fact, that it is the only disease with a hormonal deficit not treated with hormonal supplementation as the standard mode of therapy. Conventional therapy is based on oral calcium and vitamin D substitution. This treatment is often complicated, especially in adjusting the dosage of calcium and vitamin D supplementation and also because of the numerous complications affecting virtualy every system in the human body. Generally, these complications are divided into skeletal and nonskeletal. Changes in bone mineral density and microarchitecture are the main skeletal complications, and they may lead to an increased risk of fractures. Kidney function progressively declines over the course of hypoparathyroidism, sometimes leading to end stage kidney disease. Morphological changes of the kidneys are also present in the form of nephrocalcinosis and nephrolithiasis. The cardiovascular system is especially susceptible to rapid changes in serum calcium levels, that can lead to malign arrhytmias. Paresthesias, seizures, bronchospasms or laryngospasms are associated with low calcium levels as well. The function of immune system is impaired in hypoparathyroidism, resulting in higher rate of infections in these patients, requiring hospitalisation more often compared to patients with adequate parathyroid function. Psychological changes are also well documented in hypoparathyroidism and combined with the other aforementioned complications, significantly reduce the quality of life of the patients suffering from this disease. Recombinant parathormone treatment is a promising treatment option of hypoparathyroidism. The efficacy of this therapy is documented by it´s ability to stabilize serum calcium levels, calciura and phosphatemia. Parathormone treatment also reduces the worsening of renal function and reverses changes in bone structure present in hypoparathyroidism. Unfortunately, this therapy is not readily available.

Keywords: complications, hypoparathyidism, therapy.

Accepted: February 9, 2024; Published: February 26, 2024  Show citation