| Hypoparathyroidism is an uncommon hormonal (endocrine) disorder in which the glands located near the thyroid gland at the front of the neck (parathyroid glands) fail to produce enough parathyroid hormone (PTH). This hormone, along with vitamin D and a hormone produced by the thyroid gland (calcitonin), regulates the level of calcium in the body. Deficiency of parathyroid hormone reduces calcium levels in the blood (hypocalcemia) and may result in elevated blood levels of phosphorus (hyperphosphatemia). A low level of calcium in the body can lead to tetany, a condition that causes muscle spasms, twitching, or cramping; occasionally, seizures may also develop.
There are several rare syndromes that cause hereditary hypoparathyroidism, where the parathyroid glands may be absent from birth (congenital hypoparathyroidism), or they may cease to function for no apparent reason (idiopathic hypoparathyroidism).
Hypoparathyroidism may also be acquired, usually after radiation therapy or surgery on the thyroid gland. Low levels of magnesium prevent the secretion of parathyroid hormone (functional hypoparathyroidism).Risk: Risk factors include a family history of hypoparathyroidism or other endocrine/autoimmune disorders; recent surgery on the neck, thyroid or parathyroid glands; or radiation to the neck. Hypoparathyroidism affects men and women equally and tends to occur in those younger than 16 years or older than 40 years of age. Incidence and Prevalence: Hypoparathyroidism is a very rare disease, affecting only about 4 in every 100,000 people (Brown). |
Source: Medical Disability Advisor
| History: Symptoms may include tingling in the lips; numbness around the mouth, in the fingertips, and/or toes; muscle cramps in the lower back and legs; or hoarseness. When calcium levels become extremely low, a life-threatening syndrome known as tetany may occur. Symptoms of tetany include scattered muscle twitching and cramps, difficulty in swallowing, difficulty breathing, or generalized seizures (especially in individuals with epilepsy). The individual may experience fatigue, anxiety, or personality changes in ongoing (chronic) hypoparathyroidism. Physical exam: Chronic hypocalcemia may lead to puffy, coarse, dry skin, and is also associated with clouding of the lens of the eye (cataract). An irregular heartbeat may be present.
When there is severe calcium deficiency due to hypoparathyroidism, tapping on the facial nerve in front of the ear will cause contraction of muscles on the same side of the face (Chvostek's sign). In addition, compressing the nerves of the upper arm will cause muscle spasm (Trousseau's phenomenon). Tests: Blood tests measure levels of calcium, total protein or albumin, phosphate, magnesium, and parathyroid hormone. An electrocardiogram (ECG) can detect an abnormality in the electrical activity of the heart. |
Source: Medical Disability Advisor
| Individuals are treated with a lifelong regimen of oral calcium and vitamin D supplements to maintain the blood calcium at a normal level. Vitamin D is necessary to increase the absorption of calcium from the diet. Functional hypoparathyroidism, caused by magnesium deficiency, is corrected by taking magnesium supplements.
Severe hypocalcemia is a medical emergency that can lead to a serious condition called tetany. Immediate treatment with intravenous calcium in a hospital setting is necessary. Spasm of the throat muscles can make breathing difficult, necessitating intubation or surgery (tracheostomy) to keep the airway open.
Currently, clinical trials are underway for the use of parathyroid hormone (PTH) in treating osteoporosis. PTH may soon be available for treating people with hypoparathyroidism. |
Source: Medical Disability Advisor
| Short-term (acute) hypoparathyroidism usually responds well to treatment, particularly if it occurs as a complication of surgery and is detected quickly. When the disease has been chronic, permanent damage such as calcium deposits in the brain or clouding of the lens of the eye (cataracts) can occur. |
Source: Medical Disability Advisor
| Over treatment with calcium or vitamin D may lead to kidney damage or the formation of kidney stones (nephrolithiasis) and impaired renal function. |
Source: Medical Disability Advisor
| No work restrictions or accommodations should be necessary once the individual has received treatment. |
Source: Medical Disability Advisor
| If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case. Regarding diagnosis:
- Has the diagnosis of hypoparathyroidism been confirmed?
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Has the underlying cause been identified? Is the underlying cause receiving appropriate treatment?
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Has individual experienced any complications related to the hypoparathyroidism?
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Does individual have an underlying condition that may impact recovery?
Regarding treatment:
- Is individual compliant with the physician's instructions for treatment of this condition as well as the treatment of any underlying condition? Has hypoparathyroidism responded to treatment?
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Does individual experience episodes of tetany? Is emergency intervention available? Has individual (or caretaker) been educated in early symptoms and how to access emergency intervention?
Regarding prognosis:
- Was hypoparathyroidism detected early and treated effectively? If symptoms persist, has underlying condition been resolved?
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Is individual receiving appropriate follow-up? Does individual comply with follow-up regimen?
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Source: Medical Disability Advisor
| Brown, Todd T. "Hypoparathyroidism." MedlinePlus. 6 Jan. 2003. National Library of Medicine. 11 Oct. 2004 <http://medlineplus.gov/>. |
Source: Medical Disability Advisor