5-Minute Emergency Consult
Hypoparathyroidism
Hypoparathyroidism is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
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
- Bartter syndrome:
- May be accompanied by hypokalemia and metabolic alkalosis
- 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 fourth and fifth metacarpals and metatarsals (type I pseudohypoparathyroidism)
Etiology
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
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
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
- Bartter syndrome:
- May be accompanied by hypokalemia and metabolic alkalosis
- 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 fourth and fifth metacarpals and metatarsals (type I pseudohypoparathyroidism)
Etiology
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
Schaider, Jeffrey J., et al., editors. "Hypoparathyroidism." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307606/all/Hypoparathyroidism.
Hypoparathyroidism. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307606/all/Hypoparathyroidism. Accessed April 14, 2021.
Hypoparathyroidism. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th edition). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307606/all/Hypoparathyroidism
Hypoparathyroidism [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2021 April 14]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307606/all/Hypoparathyroidism.
* Article titles in AMA citation format should be in sentence-case
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