Hypoparathyroidism

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Hypoparathyroidism
Definition
Hypoparathyroidism is a disorder in which insufficient parathyroid hormone (PTH) is secreted from the parathyroid glands, resulting in abnormally low levels of calcium in the blood. The parathyroid glands are four pea-sized glands located next to the thyroid gland in the neck; they secrete PTH, which regulates the level of calcium in the blood.
Thyroid and Parathyroid Glands: Posterior (Back) View

Causes
Several factors are known to cause hypoparathyroidism, including:
• Absence of the parathyroid glands at birth
• Damage to the parathyroid glands by radiation
• Drugs (cimetidine, aluminium, doxorubicin)
• Removal of the parathyroid glands
• Underlying autoimmune disorders
• Genetics
• DiGeorge syndrome
• Magnesium deficiency ( alcoholism , malnutrition)
• Autoimmune: polyglandular autoimmunity type 2 or autoimmune hypopararthyroidism
• Other causes: metal overload and infiltration by cancer or infections ( HIV )
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
The following factors increase your chance of developing hypoparathyroidism:
• Thyroid or parathyroid surgery
• Family history of hypoparathyroidism
• Age: under 16 years old or over 40 years old
Symptoms
If you experience any of these symptoms, do not assume it is due to hypoparathyroidism. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your physician.
• Weakness
• Muscle cramps or twitching
• Pain
• Difficulty with walking
• Tingling around the mouth, hands, and feet
• Excessive nervousness
• Loss of memory
• Personality change or mood swings
• Blurred vision due to cataracts
• Hoarseness
• Thin, brittle nails
• Dry and scaly skin
• Seizures
• Wheezing or shortness of breath
• Parkinsonism
Diagnosis
Your doctor will ask about your symptoms and medical history, and perform a physical exam. You may be referred to a doctor who specializes in hormone disorders (endocrinologist).
Tests may include the following:
• Blood Tests – to measure calcium, magnesium, phosphorus, vitamin D, and/or PTH
• Urine Test – to measure calcium excretion
• X-ray or CT Scan of the skull and bones
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Calcium and Vitamin D Supplementation
Hypoparathyroidism is treated by oral calcium and vitamin D supplementation, which usually must be taken indefinitely. In addition, calcium may be administered by injection when immediate symptom relief is necessary.
Parathyroid Gland Transplantation
Transplantation of previously preserved pararthyroid gland is a successful procedure in approximately 25% of cases with normalization of blood calcium.
Prevention
There are no guidelines for preventing hypoparathyroidism.