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    Hypoparathyroidism

    Hypoparathyroidism is a topic covered in the 5-Minute Emergency Consult.

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    Basics

    Description

    • Hypoparathyroidism occurs secondary to a deficiency in parathyroid hormone (PTH)
    • Pseudohypoparathyroidism occurs secondary to end-organ unresponsiveness to PTH
    • PTH:
      • Decreases urinary Ca2+ loss
      • Increases urinary PO4 loss
      • Stimulates vitamin D conversion from 25(OH)-D to 1,25(OH)2-D in kidney
      • Liberates Ca2+ and PO4 from bone
    • Hypocalcemia is the major metabolic derangement
    • Calcitonin:
      • Promotes deposition of Ca2+ and PO4 into bone (produced primarily in C cells in thyroid)
    • Magnesium:
      • Cofactor in production of PTH
      • Essential for action of PTH in target tissues
    • Hypoparathyroidism:
      • Primary failure of the parathyroid gland (may have associated Addison disease)
    • Pseudohypoparathyroidism:
      • Tissue unresponsiveness with elevated PTH levels
      • Associated with hypothyroidism and hypogonadism
    • Genetics:
      • Congenital absence
      • DiGeorge syndrome:
        • Hypoparathyroidism
        • Thymic dysplasia
        • Severe immunodeficiency
      • Wilson disease:
        • Destruction of gland owing to copper deposition
      • Autoimmune polyglandular syndrome type I
        • Hypoparathyroidism
        • Adrenal insufficiency
        • Mucocutaneous candidiasis
      • Albright syndrome (hereditary osteodystrophy):
        • Short stature
        • Obesity
        • Round face
        • Short neck
        • Short 4th and 5th metacarpals and metatarsals (type I pseudohypoparathyroidism)

    Etiology

    • Failure of parathyroid gland:
      • Autoimmune destruction
      • Surgical interruption of blood supply or gland removal
      • Radiation damage
      • Hypomagnesemia (PTH cofactor)
    • End-organ unresponsiveness to PTH

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    Citation

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    TY - ELEC T1 - Hypoparathyroidism ID - 307606 ED - Barkin,Adam Z, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Shayne,Philip, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307606/all/Hypoparathyroidism PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -