Update on hypoparathyroidism

Curr Opin Rheumatol. 2019 Jul;31(4):381-387. doi: 10.1097/BOR.0000000000000618.

Abstract

Purpose of review: Hypoparathyroidism is a rare endocrine disorder characterized by low or insufficient parathyroid hormone (PTH) concentrations leading to hypocalcemia, hyperphosphatemia, and markedly reduced bone turnover. Despite being a rare disease, hypoparathyroidism has a profound impact on affected patients.

Recent findings: Recent epidemiologic surveys demonstrate a prevalence of between 5.3 and 40/100 000, confirming the orphan status of this disease. There is a female predominance, and anterior neck surgery is the most common etiology. Recent studies have better elucidated the chronic manifestations of the disease, impacting quality of life and multiple organ systems including the renal, cardiovascular, and skeletal systems. There are now data on longer term use of parathyroid hormone (PTH) and PTH analogs.

Summary: This review focuses on recent contributions to the literature on the prevalence and epidemiology of the disease, risk of chronic manifestations, and treatment with PTH(1-34) and rhPTH(1-84). Further research is needed to determine the pathophysiology of complications in hypoparathyroidism and whether interventions can decrease future risk of these complications. In addition, further data are needed with regards to more physiologic dosing regimens and long-term treatment with PTH and PTH analogs.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Biomarkers / blood
  • Calcium / blood*
  • Global Health
  • Humans
  • Hypoparathyroidism / blood
  • Hypoparathyroidism / epidemiology*
  • Parathyroid Hormone / blood*
  • Prevalence
  • Protein Precursors / blood*
  • Quality of Life

Substances

  • Biomarkers
  • Parathyroid Hormone
  • Protein Precursors
  • preproparathormone
  • Calcium