Treatment of hypoparathyroidism

Best Pract Res Clin Endocrinol Metab. 2018 Dec;32(6):955-964. doi: 10.1016/j.beem.2018.12.002. Epub 2018 Dec 6.

Abstract

The goal of the clinical management of hypoparathyroidism is to correct acute and chronic hypocalcemia. Treatment of acute hypoparathyroidism via intravenous infusion of Ca++ salts, is necessary only in symptomatic patients, or in asymptomatic patients in the setting of a rapid decrease in ionized Ca++ levels. The treatment cornerstones of chronic hypoparathyroidism are oral supplementation of calcium and/or active vitamin D, that can be associated with dietary restriction of sodium and phosphates, thiazide diuretics, and phosphate binders. Notably, PTH replacement is emerging as a innovative treatment of chronic hypoparathyroidism. rhPTH (1-84) has been shown to safely reduce calcium and vitamin D dosage, and increase serum calcium levels in hypoparathyroid patients. Therefore, rhPTH (1-84) appears to represent a new option in patients with chronic hypoparathyroidism "resistant" to conventional treatment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Calcium / administration & dosage
  • Hormone Replacement Therapy
  • Humans
  • Hypocalcemia / etiology
  • Hypocalcemia / therapy
  • Hypoparathyroidism / complications
  • Hypoparathyroidism / epidemiology
  • Hypoparathyroidism / therapy*
  • Parathyroid Hormone / administration & dosage
  • Parathyroid Hormone / blood
  • Parathyroid Hormone / deficiency
  • Phosphates / administration & dosage
  • Vitamin D / administration & dosage

Substances

  • Parathyroid Hormone
  • Phosphates
  • Vitamin D
  • Calcium