Hypoparathyroidism
Hypoparathyroidism is a disease condition in which the parathyroid glands, located at the base of the neck on the thyroid glands, produce too little parathyroid hormone, known as PTH. This hormone aids in regulating the levels of calcium, phosphorus and vitamin D in the bloodstream. In patients with hypoparathyroidism, phosphorus levels increase and calcium levels decrease.
Causes of Hypoparathyroidism
Most commonly, hypoparathyroidism is the result of an injury to the parathyroid glands during thyroid or other neck surgery. In rare cases, this disorder is a side effect of the treatment of hyperthyroidism with radioactive iodine. Other causes of hypoparathyroidism include reduced blood levels of magnesium and metabolic alkalosis, in which the ph level in the body is too high. Hypoparathyroidism may also have hereditary causes. It may be the result of an adrenal insufficiency or manifest as a childhood disease known as DiGeorge syndrome which occurs because all of the parathyroid glands are missing at birth.
Risk Factors for Hypoparathyroidism
Risk factors for hypoparathyroidism include: a family history of parathyroid conditions, autoimmune disorders such as Addison's disease, and having had recent thyroid or neck surgery.
Symptoms of Hypoparathyroidism
There is a wide variety of symptoms of hypoparathyroidism since the absence of PTH has a systemic affect. Symptoms may include:
- Dry skin or hair
- Pain in the face, legs, or abdomen
- Cataracts
- Muscle cramps
- Tetany, muscle spasms of the face and limbs
- Seizures
- Tingling sensations
- Painful menstruation
In children, hypoparathyroidism may present as missing teeth, teeth that are delayed in appearing or weakened tooth enamel.
Diagnosis of Hypoparathyroidism
This disorder is diagnosed through blood tests to determine calcium, phosphorus, magnesium and PTH levels. Urine tests are also often administered to check how much calcium is being excreted. Because hypoparathyroidism may result in heart arrhythmia, patients may also undergo an EKG.
Treatment of Hypoparathyroidism
Since the goal of treatment of this condition is to restore proper vitamin and mineral balance in the body, treatment involves prescription of vitamin D and calcium carbonate supplements. Such supplements must usually be taken for life and blood levels must be regularly measured to make sure the dosages are correct. Patients with hypoparathyroidism are also typically advised to eat a diet high in calcium and low in phosphorus.
Complications of Hypoparathyroidism
When a child suffers from hypoparathyroidism, it is important that the disorder be diagnosed and treated promptly. Left untreated, dental, physical, and mental development may be impaired.
Some patients with hypoparathyroidism may suffer attacks of prolonged muscle contracts which may necessitate the intravenous administration of calcium. These contractions may be life-threatening when they involve seizures or spasms of the larynx. When patients with this disorder experience heart arrhythmias, the heart must be carefully monitored until the condition improves.
In certain cases, complications may arise from the treatment of hypoparathyroidism. If the level of vitamin D in the blood becomes elevated, or if the patient develops hypercalcemia (too much calcium in the blood) kidney function may be adversely affected.
Patients with hypoparathyroidism are also at greater risk of developing other medical problems, such as Addison's disease, Parkinson's disease, cataracts or pernicious anemia.