Related articles: Hypoparathyroidism
Definition
Hypoparathyroidism is a dysfunction that affects the parathyroid glands, characterized by insufficient parathormone synthesis and secretion (PTH). More rarely, the disorder is caused by a poor action of the same parathormone at the level of specific target organs (kidney, bone and intestine).
As a rule, the parathyroid hormone produced by the parathyroids has the function of maintaining the concentration of calcium in the blood within normal limits. In the presence of hypoparathyroidism, therefore, there is a reduction in the levels of calcium in the blood, which leads to hypocalcemia.
The most frequent cause is surgical removal of the parathyroid glands (subtotal or total parathyroidectomy).
Hypoparathyroidism can occur accidentally even following a thyroid surgery or injury during a procedure in the neck region. PTH deficiency may be transient, when at least one parathyroid is healthy and retains its function, or permanent, in the event of resection or injury of all parathyroid glands.
In some cases, hypoparathyroidism is congenital or occurs in autoimmune diseases. The idiopathic form is, instead, a rare condition, hereditary or sporadic, in which the parathyroid glands are absent or atrophic.
Most common symptoms and signs *
- Convulsions
- Muscle cramps
- Depression
- Hypocalcemia
- Hypotension
- Paresthesia
- Muscle spasms
- Fatigue with spasms (spasmophilia)
- Confusional state
Further indications
Hypoparathyroidism causes symptoms related to neuromuscular hyper-excitability. Therefore, muscle spasms, tingling and tendon reflexes may occur, especially in the upper limbs, hands and face. Furthermore, in hypocalcaemic conditions, there is a feeling of dizziness, hypotension and muscle cramps.
In the most severe forms of hypoparathyroidism, tetany can arise, characterized by spastic, forced and involuntary contractions of the skeletal muscles.
The diagnosis of hypoparathyroidism is based on the finding of an unusually low level of calcium in the blood (hypocalcemia), associated with hyperphosphoremia and low PTH values.
The treatment of hypoparathyroidism aims to normalize calcium concentrations in the blood and involves the constant administration of appropriate doses of calcium and vitamin D, in the form of calcifediol or calcitriol. Tetanus crises, on the other hand, require immediate intervention with the administration of intravenous calcium gluconate.
