Hypoparathyroidism

Question 1

What is it

Answer 1

Too little PTH is produced from the parathyroid gland.

Question 2

Causes

Answer 2

Congenital
Acquired
Transient - neonates born prematurely
Inherited (pseudohypoparathyroidism, pseudopseudohypoparathyroidism)

Question 3

Examples of congenital causes

Answer 3

DiGeorge syndrome

Question 4

Examples of acquired causes of hypoparathyroidism

Answer 4

Complication of parathyroidectomy or thyroidectomy

Question 5

Signs and symptoms

Answer 5

Depends on cause
Myalgia
Abdo pain, muscle spasms, seizures, fatigue, headaches, carpopedal spasm, Chvostek’s sign, Trousseau’s sign

Question 6

Investigations

Answer 6

PTH level
Serum calcium
Serum phosphate
Bloods - FBC, U/Es, LFTs, creatinine, urea
ECG - arrhythmias
ECHO - cardiac structural defects
Radiology

Question 7

Why is radiology a possible investigation

Answer 7

Pseudohypoparathyroidism patients have shorter 4th and 5th metacarpals

Question 8

Hypoparathyroidism:
Describe levels of:
PTH
Serum calcium
Serum phosphate

Answer 8

PTH - low
Serum calcium - low
Serum phosphate - low

Question 9

Pseudohypoparathyroidism:
Describe levels of:
PTH
Serum calcium
Serum phosphate

Answer 9

PTH - high
Serum calcium - low
Serum phosphate - high

Question 10

Pseudopseudohypoparathyroidism:
Describe levels of:
PTH
Serum calcium
Serum phosphate

Answer 10

All normal

Question 11

Conservative treatment

Answer 11

High calcium and low phosphate diet

Support for parents

Question 12

Medical treatment

Answer 12

Calcium and vitamin D supplements

Question 13

Complications

Answer 13

Renal calculi
Arrhythmias
Cataract formation
Dental problems