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Case Rep Nephrol 2018 4;2018:7384763. Epub 2018 Nov 4.

Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Background: Hypocalcaemia is increasingly recognized as a complication of denosumab use in Chronic Kidney Disease (CKD) patients with osteoporosis. Despite Therapeutic Goods Administration (TGA) notifications in 2013, we have subsequently encountered several cases of denosumab-induced hypocalcaemia, raising concern about lack of widespread awareness among prescribing practitioners.

Aims: We reviewed the morbidity and healthcare intervention needs of CKD patients with hypocalcaemia attributed to denosumab. Read More

Pediatr Nephrol 2018 Nov 30. Epub 2018 Nov 30.

Heidelberg University Hospital, Heidelberg, Germany.

Background: This randomized phase 3 study evaluated the efficacy and safety of cinacalcet in children with secondary hyperparathyroidism (SHPT) receiving dialysis.

Methods: This study had double-blind and open-label phases. Eligible patients aged 6-< 18 years were randomized to cinacalcet (starting dose ≤ 0. Read More

Gland Surg 2018 Oct;7(5):458-465

Department of Surgery, King Khalid University Hospital, Riyadh, Saudi Arabia.

Background: Despite a number of studies, the optimal timing of completion thyroidectomy is still controversial. This systematic review and meta-analysis aims to compare the outcomes of early versus delayed completion thyroidectomy regarding post-operative complications.

Methods: We performed a systematic review in electronic databases including: bumped, Scopus, Medline and Google Scholar to identify relevant studies. Read More

Am J Case Rep 2018 Dec 1;19:1430-1433. Epub 2018 Dec 1.

Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.

BACKGROUND Idiopathic basal ganglia calcification, also known as Fahr's disease or Fahr's syndrome, is a rare neurological disorder characterized by abnormal calcified deposits in the basal ganglia. Here, we report a case of Fahr's syndrome with calcification of the basal ganglia due to hypoparathyroidism in a patient with seizures. CASE REPORT A 52-year-old male patient visited our clinic with seizures. Read More

Neurol India 2018 Nov-Dec;66(6):1795-1800

Pediatric Intensive Care Unit, Department of Pediatrics, BL Kapur Super Specialty Hospital, New Delhi, India; Epilepsy Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.

Surg Innov 2018 Dec 3:1553350618817145. Epub 2018 Dec 3.

1 Department of Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.

Objective: Despite gaining popularity, bilateral axillo-breast approach robotic thyroidectomy (BABA RT) remains controversial. We performed a meta-analysis to evaluate the safety and effectiveness of BABA RT compared with open thyroidectomy (OT) in thyroid disease.

Methods: A literature search was conducted using various databases, including PubMed, Web of Science, and Cochrane Library, up to February 2018. Read More

Expert Rev Clin Pharmacol 2018 Dec 2. Epub 2018 Dec 2.

a Department of Neurology and Psychiatry , Assiut University Hospital , Assiut , Egypt.

Introduction: Uremic syndrome of chronic kidney disease (CKD) is a term used to describe clinical, metabolic and hormonal abnormalities associated with progressive kidney failure. It is a rapidly growing public health problem worldwide. Nervous system complications occur in every patient with uremic syndrome of CKD. Read More

Endocrinol Metab (Seoul) 2018 Dec;33(4):485-492

Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Background: Increasing evidence supports interplay between aldosterone and parathyroid hormone (PTH), which may aggravate cardiovascular complications in various heart diseases. Negative structural cardiovascular remodeling by primary aldosteronism (PA) is also suspected to be associated with changes in calcium levels. However, to date, few clinical studies have examined how changes in calcium and PTH levels influence cardiovascular outcomes in PA patients. Read More

Arch Pathol Lab Med 2018 Nov 30. Epub 2018 Nov 30.

From the Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.

Tumor lysis syndrome (TLS) is an acute, life-threatening disease among adults and children that is associated with the initiation of cytoreductive therapy in the treatment of malignancy. A pattern of metabolic derangements occurs as a result of a massive release of intracellular contents into the systemic circulation. Characteristic findings include hyperuricemia, hyperphosphatemia, hyperkalemia, hypocalcemia, and uremia, all of which can lead to cardiac arrhythmia, seizures, renal failure, and sudden death. Read More

J Bone Miner Res 2018 Nov 29. Epub 2018 Nov 29.

Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Dept. at the Hanusch Hospital, Vienna, Austria.

The role of the calcium-sensing receptor (CaSR) as a regulator of parathyroid hormone secretion is well established, but its function in bone is less well defined. In an effort to elucidate the CaSR's skeletal role, bone tissue and material characteristics from patients with autosomal dominant hypocalcemia (ADH), a genetic form of primary hypoparathyroidism caused by CASR gain-of-function mutations, were compared to patients with postsurgical hypoparathyroidism (PSH). Bone structure and formation/resorption indices and mineralization density distribution (BMDD), were examined in transiliac biopsy samples from PSH (n = 13) and ADH (n = 6) patients by histomorphometry and quantitative backscatter electron imaging, respectively. Read More

Oxf Med Case Reports 2018 Dec 21;2018(12):omy103. Epub 2018 Nov 21.

Departments of Emergency Medicine & Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Bridgeport Hospital, Yale-New Haven Health System, Bridgeport, CT, USA.

We report the case of a 52-year-old gentleman, admitted to the medical intensive care unit with multiple organ system dysfunction due to acute severe pancreatitis. He was found to have severe hypocalcemia, bradycardia and an electrocardiogram (EKG) showing ST-segment elevation in infero-lateral leads. The patient was treated with intravenous calcium gluconate with prompt improvement of heart rate and reversal of EKG changes. Read More

J Intern Med 2018 Nov 28. Epub 2018 Nov 28.

Department of Medicine, Haukeland University Hospital, Bergen, Norway.

Background: Patients with hypoparathyroidism are at risk of both hypocalcemic and hypercalcemic crisis. Patients report that health professionals do not always respond adequately in an acute situation. The extent and handling of severe hypo- and hypercalcemia in hypoparathyroidism is unknown. Read More

OTO Open 2017 Jul-Sep;1(3):2473974X17728257. Epub 2017 Aug 24.

Head and Neck Surgical Oncology, Methodist Estabrook Cancer Center, Nebraska Methodist Health System, Omaha, Nebraska, USA.

Objective: To examine outcomes of pediatric thyroidectomy in the context of training background, institution, and experience of the surgeon.

Study Design: Case series with chart review.

Setting: A tertiary academic medical center and a pediatric hospital. Read More

J Clin Med 2018 Nov 24;7(12). Epub 2018 Nov 24.

Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan.

Osteogenesis imperfecta (OI) is a connective tissue disorder that is characterized by low bone density leading to recurrent fractures. The efficacy of the anti-resorption drug denosumab for OI with osteoporosis is still largely unknown. We herein describe the clinical outcomes of eight osteoporotic cases of OI to examine the effects and safety of denosumab. Read More

Int J Surg 2018 Nov 23;60:210-215. Epub 2018 Nov 23.

Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. Electronic address:

Background: The extent of total thyroidectomy in the management of multinodular goiter remains unclear. Compared to primary thyroidectomy, secondary total thyroidectomy is more difficult to perform and carries a significantly higher risk of postoperative complications such as recurrent laryngeal nerve (RLN) palsy or hypoparathyroidism. In this study, we aimed to evaluate the efficacy and safety of intraoperative carbon nanoparticle (CN) mapping in patients undergoing secondary total thyroidectomy. Read More

J Pediatr 2018 Dec;203:391-399.e1

Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.

Objective: To determine whether multiple daily injections of parathyroid hormone (PTH) 1-34 are safe and effective as long-term therapy for children with hypoparathyroidism.

Study Design: Linear growth, bone accrual, renal function, and mineral homeostasis were studied in a long-term observational study of PTH 1-34 injection therapy in 14 children.

Methods: Subjects were 14 children with hypoparathyroidism attributable to autoimmune polyglandular syndrome type 1 (N = 5, ages 7-12 years) or calcium receptor mutation (N = 9, ages 7-16 years). Read More

Front Endocrinol (Lausanne) 2018 8;9:656. Epub 2018 Nov 8.

Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland.

The numerous evidence showing spectrum of vitamin D effects on human health resulted in both updates of vitamin D supplementation guidelines for general population and concerns on potential risk of hypercalcaemia. The aim of this study was to analyse trends in serum 25-hydroxyvitamin D concentration (25(OH)D) change over the 30 years of operation of a single pediatric diagnostic unit. Calcium-phosphate metabolism markers and 25(OH)D concentrations were analyzed in a group that consisted of newborns and infants commissioned for diagnostics due to suspected calcium-phosphate metabolic disturbances ( = 3,163; mean age 8. Read More

Indian J Otolaryngol Head Neck Surg 2018 Dec 5;70(4):482-489. Epub 2018 Sep 5.

1Department of Otolaryngology and Head Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

To study the epidemiological, pathological characters and determine survival in patients diagnosed of having thyroid gland malignancies. Retrospective chart review of patients having thyroid gland malignancies, which were managed by the two senior authors at our tertiary care institute from January 2000 to December 2006, were performed and evaluated in terms of various clinical, operative and histological parameters. Patients in which follow up of at least 10 years are available were included in the study. Read More

J Med Imaging Radiat Oncol 2018 Nov 21. Epub 2018 Nov 21.

School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.

Introduction: The role of the radioprotector amifostine in ameliorating radiotherapy side effects in head and neck squamous cell carcinoma (HNSCC) is controversial. This trial aimed to determine whether pretreatment with amifostine reduced the incidence of Radiation Therapy Oncology Group grade ≥2 acute and late xerostomia in patients receiving definitive or adjuvant radiotherapy for HNSCC, without reducing tumour control or survival.

Methods: Between 14 September 2001 and 8 November 2004, 44 Royal Adelaide Hospital patients were randomized double-blind to receive amifostine (200 mg/m IV) or placebo (normal saline IV) 5 days/week, prior to standard radiotherapy (60-70 Gy), each having ≥75% of the parotids treated to ≥40 Gy. Read More

Paediatr Int Child Health 2018 Nov 21:1-7. Epub 2018 Nov 21.

c Department of Paediatrics , Lokmanya Tilak Municipal Medical College and General Hospital , Sion, Mumbai , India.

Background: Reports suggest that, in tetanus, magnesium sulphate (MgSO) alone may control muscle spasms, thereby avoiding sedation and mechanical ventilation.

Aim: To study the efficacy and safety of intravenous MgSO in controlling spasms and rigidity in children with tetanus.

Methods: All children with tetanus consecutively admitted over a 2-year period in a tertiary-care teaching hospital were recruited. Read More

Best Pract Res Clin Endocrinol Metab 2018 Oct 28;32(5):639-656. Epub 2018 May 28.

Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Thier 1101, 50 Blossom St, Boston, MA, 02114, USA. Electronic address:

Calcium is vital for life, and extracellular calcium concentrations must constantly be maintained within a precise concentration range. Low serum calcium (hypocalcemia) occurs in conjunction with multiple disorders and can be life-threatening if severe. Symptoms of acute hypocalcemia include neuromuscular irritability, tetany, and seizures, which are rapidly resolved with intravenous administration of calcium gluconate. Read More

Eur J Endocrinol 2018 Nov 1. Epub 2018 Nov 1.

M Brandi, Department of Surgery and Translational Medicine, University of Florence, Florence, 50139, Italy.

Purpose: review calcium homeostasis in pregnancy and provide evidence based best practice recommendations for the management of hypoparathyroidism in pregnancy Methods: We searched MEDLINE, EMBASE and Cochrane databases from January 2000 to April 1, 2018. A total of 65 articles were included in the final review.

Conclusions: During pregnancy calcitriol levels increase by 2-3 fold resulting in enhanced intestinal calcium absorption. Read More

G Chir 2018 Sep-Oct;34(5):291-296

Background: We know that benefits of MIVAT are related to a better cosmetic result and lower post-operative pain in comparison to CT. The incidence of nerve cold palsy is related to a correct identification of the recurrent laringeal nerve (RLN) as standard procedure in thyroid surgery. From September 2014 we have introduced the use of intraoperative neural monitoring(I-IONM) in all thyroidectomies in the Unit of General Surgery of University Hospital of Parma, including in MIVAT. Read More

Nat Rev Endocrinol 2018 Nov 15. Epub 2018 Nov 15.

Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.

The Ca-sensing receptor (CaSR) is a dimeric family C G protein-coupled receptor that is expressed in calcitropic tissues such as the parathyroid glands and the kidneys and signals via G proteins and β-arrestin. The CaSR has a pivotal role in bone and mineral metabolism, as it regulates parathyroid hormone secretion, urinary Ca excretion, skeletal development and lactation. The importance of the CaSR for these calcitropic processes is highlighted by loss-of-function and gain-of-function CaSR mutations that cause familial hypocalciuric hypercalcaemia and autosomal dominant hypocalcaemia, respectively, and also by the fact that alterations in parathyroid CaSR expression contribute to the pathogenesis of primary and secondary hyperparathyroidism. Read More

Surgery 2018 Nov 12. Epub 2018 Nov 12.

Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN. Electronic address:

Background: Difficulty in identifying the parathyroid gland during neck operations can lead to accidental parathyroid gland excisions and postsurgical hypocalcemia. A clinical prototype called as PTeye was developed to guide parathyroid gland identification using a fiber-optic probe that detects near-infrared autofluorescence from parathyroid glands as operating room lights remain on. An Overlay Tissue Imaging System was designed concurrently to detect near-infrared autofluorescence and project visible light precisely onto parathyroid gland location. Read More

Tunis Med 2018 Aug - Sep;96(8-09):490-494

Aim: We describe the clinical and etiological profile of patients with Fahr's syndrome (FS).

Methods: Charts of sixteen patients diagnosed with FS between 1999 and 2014 were retrospectively assessed.

Results:   The mean age at diagnosis was 44. Read More

Tunis Med 2018 Aug - Sep;96(8-09):472-476

Background: Hypoparathyroidism is a rare pediatric endocrine disease, which is caused by low circulating levels of PTH or insensitivity to its action in the target tissues.

Aim: To report the clinical and biochemical characteristics and theoutcome of 8 patients with hypoparathyroidism.

Methods: We analyzed retrospectively the results of clinical, biochemical, radiological findings of patients with hypoparathyroidism diagnosed in pediatric department of Hedi Chaker Hospital during the period 1994-2013. Read More

J Am Anim Hosp Assoc 2018 Nov 14. Epub 2018 Nov 14.

From the Department of Veterinary Medicine & Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (J.J., A.D.); Lauderdale Veterinary Specialists, Fort Lauderdale, Florida (A.C., L.T.); and Bronson Animal Disease Diagnostic Laboratory, Kissimmee, Florida (J.H.).

Clinically relevant hypocalcemia is a well-documented complication of glucocorticoid administration in people with hypoparathyroidism. The current report describes the phenomenon in a dog. A 7 yr old neutered male Pomeranian was diagnosed with immune-mediated thrombocytopenia, immune-mediated hemolytic anemia, and primary hypoparathyroidism. Read More

Case Rep Surg 2018 23;2018:9261749. Epub 2018 Oct 23.

Division of General Surgery, Department of Surgery, University Health Network, Canada.

A 71-year-old man with known history of atrial fibrillation (treated with routine rivaroxaban therapy) was found to have incidental biochemical elevated calcium and parathyroid hormone (PTH) levels. His physical examination demonstrated the presence of a palpable right neck mass. Subsequent imaging studies revealed a large parathyroid mass as well as multiple bone lesions, raising the suspicion of parathyroid carcinoma. Read More

J Oncol Pharm Pract 2018 Nov 12:1078155218812945. Epub 2018 Nov 12.

Department of Pharmacy, Princess Margaret Cancer Centre, Toronto, ON, Canada.

This is a case report of a patient who developed severe, irreversible hypocalcemia after receiving one dose of pamidronate 90 mg for hypercalcemia of malignancy. Hypocalcemia is a known risk of bisphosphonate treatments, but the incidence of severe hypocalcemia is rare, and the risk factors are well established. However, in the treatment of hypercalcemia of malignancy, the treatment objective is to reduce the elevated serum calcium level, and the bisphosphonate is usually given as one time dose only. Read More

J Clin Endocrinol Metab 2018 Nov 9. Epub 2018 Nov 9.

Nephrology, Bambino Gesù Children's Research Hospital.

Context: Type 1A Pseudohypoparathyroidism (PHP-1A) is characterized by target organ resistance to parathyroid hormone (PTH). Patients can show various dysmorphic features, but renal failure is not classically described.

Case Description: A female patient came to our attention at the age of seven years with characteristic signs of PTH resistance, namely hypocalcemia, hyperphosphatemia and high serum PTH levels. Read More

ASAIO J 2018 Nov 7. Epub 2018 Nov 7.

Department of Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Italy.

During citrate-based Continuous Renal Replacement Therapy (CRRT), an infusion of calcium is necessary to replace the calcium lost in the effluent. The replacement takes place through a central venous catheter (CVC) that is primed with saline solution. Thus, we hypothesized a potential systemic anticoagulation because of unchelated citrate reaching the patient at the start of CRRT because of 0. Read More

Surgery 2018 Nov 6. Epub 2018 Nov 6.

Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX. Electronic address:

Background: Patients undergoing subtotal parathyroidectomy for renal-origin hyperparathyroidism often develop postoperative hypocalcemia, requiring calcitriol and intravenous calcium (Postop-IVCa). We hypothesized that in subtotal parathyroidectomy for renal-origin hyperparathyroidism, preoperative calcitriol treatment reduces the use of postoperative administration of intravenous calcium.

Methods: A retrospective chart review compared subtotal parathyroidectomy for renal-origin hyperparathyroidism patients who received preoperative calcitriol treatment with those patietns who did not receive preoperative calcitriol treatment at one institution. Read More

PLoS One 2018 9;13(11):e0207088. Epub 2018 Nov 9.

Department of Surgical Oncology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P. R. China.

Introduction: Postoperative hypocalcemia is the most common complication of thyroidectomy. Incidental parathyroidectomy (IP) was thought to be associated with postoperative hypocalcemia. However, according to previous studies, the risk factors and clinical outcomes of IP remain controversial. Read More

Oman Med J 2018 Nov;33(6):453-462

Obesity, Endocrine and Metabolism Centre, King Fahad Medical City, Riyadh, Saudi Arabia.

Though hypocalcemia in pregnancy is not often reported in the literature, it occurs in cases of hypoparathyroidism and in mothers with severe dietary inadequacy. Hypocalcemia during pregnancy can pose numerous problems to the mother and fetus. It is associated with hypertensive disorders and can increase the risk of numerous problems such as preeclampsia and fetal growth disorders. Read More

Eur J Endocrinol 2018 Nov 1. Epub 2018 Nov 1.

B Decallonne, Department of Endocrinology, University Hospitals Leuven, Leuven, 3000, Belgium.

Objective: Chronic hypoparathyroidism and its treatment may lead to symptoms and complications affecting quality of life. We determined complications in chronic hypoparathyroid patients.

Design: Retrospective cross-sectional study of patients with chronic hypoparathyroidism treated with active vitamin D supplements in a tertiary care centre during the year 2015. Read More

Eur J Endocrinol 2018 Nov 1. Epub 2018 Nov 1.

L Castaño, Endocrinology and Diabetes Research Group,Cruces University Hospital, CIBERDEM, CIBERER, UPV-EHU, BioCruces Health Research Institute, Barakaldo, Spain.

Objective: Molecular diagnosis is a useful diagnostic tool in calcium metabolism disorders. The calcium-sensing receptor (CaSR) is known to play a central role in the regulation of extracellular calcium homeostasis. We performed clinical, biochemical and genetic characterization of sequence anomalies in this receptor in a cohort of 130 individuals from 82 families with suspected alterations in the CASR gene, one of the largest series described. Read More

Case Rep Oncol Med 2018 14;2018:2059364. Epub 2018 Oct 14.

Division of Hematology and Oncology, George Washington University School of Medicine, USA.

Background: Denosumab has become the preferred agent over zolendronic acid to help prevent skeletal-related events in patients with metastatic bone disease and multiple myeloma because it is approved for use in those with kidney dysfunction. However, denosumab has been linked to cases of hypocalcemia, particularly in those with advanced kidney disease.

Case Presentation: We present the case of a patient with metastatic prostate cancer and chronic kidney disease due to obstructive nephropathy who developed severe hypocalcemia and hypomagnesemia after denosumab injection, which required intensive care unit admission, aggressive calcium supplementation, and hemodialysis assistance. Read More

Auris Nasus Larynx 2018 Nov 2. Epub 2018 Nov 2.

Shizuoka Prefectural Hospital Organization, Department of Medical Genetics, Shizuoka, Japan.

Hypoparathyroidism-deafness-renal dysplasia (HDR) syndrome is a rare autosomal dominant disorder primarily caused by GATA3 haploinsufficiency and is challenging to diagnose in early childhood. We report a Japanese family with HDR syndrome and congenital choanal atresia. The 6-year-old female proband was diagnosed with epilepsy at the age of three. Read More

J Bone Miner Res 2018 Nov 5. Epub 2018 Nov 5.

Unit of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy.

Post-surgical hypoparathyroidism (hypoPT) increases fatigue and seems to affect the risk of mortality. Cardiovascular autonomic neuropathy (CAN) is an impairment of the cardiovascular autonomic system, a cause of increased mortality and associated with increased fatigability. The aim of this study is to evaluate CAN in hypoPT and its relationship with hypocalcemia, PTH levels and hyperphosphatemia. Read More

Brain Behav Immun 2019 Jan 27;75:181-191. Epub 2018 Oct 27.

Department of Surgery, Rutgers-New Jersey Medical School, Newark, NJ 07103, USA; Center for Immunity and Inflammation, Rutgers-New Jersey Medical School, Rutgers Biomedical Health Sciences, Newark, NJ 07103, USA. Electronic address:

Physical exercise is one of the most important factors improving quality of life, but it is not feasible for patients with morbidity or limited mobility. Most previous studies focused on high-intensity or long-term exercise that causes metabolic stress or physiological adaption, respectively. Here, we studied how moderate-intensity swimming affects systemic inflammation in 6-8 week old C57BL/6J male mice during endotoxemia. Read More

Endocrinol Diabetes Nutr 2018 Nov 1. Epub 2018 Nov 1.

Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España.

Background: Permanent hypoparathyroidism is the most common long-term complication after total thyroidectomy, causing significant morbidity and requiring long-term replacement therapy. Our study objective was to assess whether intact parathyroid hormone (iPTH) levels on the first day after total thyroidectomy are a good predictor of permanent hypoparathyroidism.

Patients And Methods: A retrospective observational study of all patients undergoing total thyroidectomy between January 2009 and December 2014. Read More

Endocrinol Metab Clin North Am 2018 12;47(4):901-915

Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY 10032, USA. Electronic address:

The history of parathyroid hormone (PTH) replacement therapy for hypoparathyroidism begins in 1929. In 2015, the Food and Drug Administration approved recombinant human PTH(1-84) [rhPTH(1-84)] as a treatment for hypoparathyroidism. Long-term studies of rhPTH(1-84), up to 6 years, have demonstrated continued efficacy of this replacement agent. Read More

Endocrinol Metab Clin North Am 2018 12;47(4):889-900

Endocrine Research Unit, Department of Medicine, San Francisco Department of Veterans Affairs Medical Center, University of California, San Francisco, 111N, 1700 Owens Street, 3rd Floor Room 369, San Francisco, CA 94158, USA. Electronic address:

Conventional therapy of hypoparathyroidism consists of oral calcium and either activated vitamin D or vitamin D supplements at varying doses. Although adjusting dosing of calcium and/or activated vitamin D or vitamin D itself, the serum calcium should be obtained weekly or monthly depending on the clinical situation. Calcium supplementation in hypoparathyroidism usually consists of calcium carbonate because it is 40% elemental calcium by weight. Read More

Endocrinol Metab Clin North Am 2018 12 12;47(4):865-888. Epub 2018 Oct 12.

Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, 50 Blossom street, Boston, MA 02114, USA; Pediatric Nephrology Unit, Massachusetts General Hospital, Harvard Medical School, 50 Blossom street, Boston, MA 02114, USA.

Pseudohypoparathyroidism (PHP) refers to a heterogeneous group of uncommon, yet related metabolic disorders that are characterized by impaired activation of the Gsα/cAMP/PKA signaling pathway by parathyroid hormone (PTH) and other hormones that interact with Gsa-coupled receptors. Proximal renal tubular resistance to PTH and thus hypocalcemia and hyperphosphatemia, frequently in presence of brachydactyly, ectopic ossification, early-onset obesity, or short stature are common features of PHP. Registries and large cohorts of patients are needed to conduct clinical and genetic research, to improve the still limited knowledge regarding the underlying disease mechanisms, and allow the development of novel therapies. Read More

Endocrinol Metab Clin North Am 2018 12 11;47(4):855-864. Epub 2018 Oct 11.

Section of Endocrinology, Department of Medicine, University of Chicago, 5841 S. Maryland, MC1027, Chicago, IL 60637, USA. Electronic address:

Patients with hypoparathyroidism have a multitude of physical, emotional, and cognitive complaints consistent with reduced quality of life (QOL). Impaired QOL in patients treated with conventional therapy with calcium and active vitamin D has been documented in epidemiologic (registry) studies, case-controlled studies, and surveys, and at baseline in clinical trials of parathyroid hormone (PTH). Treatment with PTH has been shown to improve QOL in some but not all studies. Read More

Endocrinol Metab Clin North Am 2018 12 11;47(4):839-853. Epub 2018 Oct 11.

Department of Medicine, Division of Endocrinology, Indiana University School of Medicine, 1120 West Michigan Street Cl 365, Indianapolis, IN 46202, USA. Electronic address:

Hypocalcemia and hyperphosphatemia are the pathognomonic biochemical features of hypoparathyroidism, and result directly from lack of parathyroid hormone (PTH) action on the kidney. In the absence of PTH action, the renal mechanisms transporting calcium and phosphate reabsorption deregulate, resulting in hypocalcemia and hyperphosphatemia. Circulating calcium negatively regulates PTH secretion. Read More

Endocrinol Metab Clin North Am 2018 12 12;47(4):809-823. Epub 2018 Oct 12.

Division of Endocrinology and Diabetes, The Center for Bone Health, The Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, 3615 Civic Center Boulevard, Abramson Research Building, Room 510A, Philadelphia, PA 19104, USA.

Hypoparathyroidism is characterized by hypocalcemia and hyperphosphatemia and is due to insufficient levels of circulating parathyroid hormone. Hypoparathyroidism may be an isolated condition or a component of a complex syndrome. Although genetic disorders are not the most common cause of hypoparathyroidism, molecular analyses have identified a growing number of genes that when defective result in impaired formation of the parathyroid glands, disordered synthesis or secretion of parathyroid hormone, or postnatal destruction of the parathyroid glands. Read More

Endocrinol Metab Clin North Am 2018 12 11;47(4):797-808. Epub 2018 Oct 11.

Calcium Disorders Clinic, McMaster University, 50 Charlton Ave East, Hamilton, Ontario L8N 4A6, Canada. Electronic address:

Hypoparathyroidism is a metabolic disorder characterized by hypocalcemia, hyperphosphatemia, and inadequate levels of or function of parathyroid hormone (PTH). The authors review the nonsurgical or medical causes of hypoparathyroidism. The most common of the nonsurgical causes is autoimmune destruction of the parathyroid. Read More