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Secondary Hypoparathyroidism


Presentation

  • Usually, it presents with hypocalcemia. Even if there is no established therapeutic treatment, vitamin D or its analogues are required.[ncbi.nlm.nih.gov]
  • Presentation of a rare cause of hypocalcemia in childhood and the necessity of measuring serum electrolyte levels in patients presenting with afebrile seizures. a 7.5-year-old female child presented with afebrile seizures lasting 5 min with postictal[ruralneuropractice.com]
  • This presentation alone is enough to stratify the patient as a high risk for sudden cardiac death and to consider implantation of an automated internal defibrillator.[innovationsincrm.com]
  • Our case is the fourth case of impetigo herpetiformis initially presented during puerperium and the first case of puerperal impetigo herpetiformis that is precipitated by secondary hypoparathyroidism.[casesjournal.biomedcentral.com]
  • She presented slight oral dyskinesia, mild plastic hypertonia at the lower limbs, postural instability and a slight but global hypokinesia.[functionalneurology.com]
Lymphadenopathy
  • IH is usually associated with systemic features as fever, sweating, tachycardia, nausea, diarrhea, vomiting, lymphadenopathy, splenomegaly and tetany, in severe cases renal or cardiac failure may occur.[casesjournal.biomedcentral.com]
Chills
  • Few days later, the rash progressed and involved most of her body, she felt weak and developed chills. On examination, she appeared ill with a blood pressure of 90/60, pulse rate of 120/min, temperature of 38 C and respiratory rate of 20/min.[casesjournal.biomedcentral.com]
Stridor
  • However, acute hypocalcemia usually results in severe symptoms including laryngospasm, stridor, airway obstruction, neuromuscular irritability, cognitive impairment, prolonged QT interval, and cardiac arrhythmias.[ruralneuropractice.com]
  • Hypoparathyroidism has wide variety of presentations: from the asymptomatic patient with dramatically low serum calcium to the acutely symptomatic patient with neuromuscular irritability, tetany, painful muscle cramps, stridor, and even seizures with[bestpractice.bmj.com]
  • Stridor. Convulsions (usually grand mal). Syncope. Emotional lability, anxiety and depression, confusion. Memory impairment. Lethargy. Headaches. Brittle nails. Dry hair and skin. Painful menstruation.[patient.info]
Generalized Seizure
  • Nine patients presented with a history of generalized seizures and two were in acute hypocalcemic crisis at the time of admission.[ruralneuropractice.com]

Workup

Erythroblast
  • Thalassaemia, an inherited autosomal recessive blood disease, caused by the reduced capacity of erythroblasts to synthesize one of the chains that build up hemoglobine.[endocrine-abstracts.org]
Torsades De Pointes
  • Mechanisms in adrenergic dependent onset of torsades de pointes. Pacing Clin Electrophysiol 1997; 20:88–94. Khan A. Clinical and therapeutic aspects of congenital and acquired long QT syndrome. Am J Med 2002; 112:58–66.[innovationsincrm.com]

Treatment

  • RESULTS: (1) In the treatment group, the levels of serum corrected calcium, phosphorus and calcium-phosphate product began to decline after 1 month and exhibited further decrease 3 months later.[ncbi.nlm.nih.gov]
  • Even if there is no established therapeutic treatment, vitamin D or its analogues are required.[ncbi.nlm.nih.gov]
  • However, early diagnosis and treatment of hypocalcemia reduces the progression of basal ganglia calcification.[ruralneuropractice.com]
  • Results: (1) In the treatment group, the levels of serum corrected calcium, phosphorus and calcium-phosphate product began to decline after 1 month and exhibited further decrease 3 months later.[karger.com]
  • The awareness of the possible occurrence of impetigo herpetiformis during the puerperium allows early diagnosis, treatment and prevention of maternal complications.[casesjournal.biomedcentral.com]

Prognosis

  • Support Groups: Expectations (prognosis): The outcome for secondary hyperparathyroidism depends on the underlying cause. When treated, rickets generally has a good prognosis. Other causes of secondary hyperparathyroidism have variable outcomes.[uclahealth.org]
  • Prognosis The regular monitoring required to ensure appropriate calcium levels means that the prognosis is challenging for many people. This may improve if synthetic PTH becomes widely available.[patient.info]
  • Prognosis Hypoparathyroidism can be a temporary condition that stops when its cause is treated, or a permanent condition.[healthand.com]
  • RISULTATI ESTETICI) DELLA CHIRURGIA MININVASIVA CHE VIENE EFFETTUATA SIA NELLA CHIRURGIA TIROIDEA CHE NELLA CHIRURGIA PARATIROIDEA UNA ULTERIORE LINEA DI RICERCA E' LO STUDIO SULLA UTILITA' DEGLI ONCOGENI BRAF E RAS NELLA PIANIFICAZIONE CHIRURGICA E NELLA PROGNOSI[aosp.bo.it]
  • Prognosis Medical therapy is effective in most patients. Some patients may require parathyroidectomy.[boneandspine.com]

Etiology

  • Hypoparathyroidism is a rare disease in childhood, characterized by inadequate PTH, resulting in hypocalcemia and hyperphosphatemia. [3] Management of hypoparathyroidism is complex, depending on underlying etiology and is individualized, depending on[ruralneuropractice.com]
  • Thus, idiopathic hypoparathyroidism and resulting hypoparathyroid cataract are relatively rare, where the underlying etiologies and pathogenesis remain to be clarified.[omicsonline.org]
  • Presentation of hypoparathyroidism: etiologies and clinical features. J Clin Endocrinol Metab. 2016 Jun;101(6):2300-12. [2] Shoback D. Clinical practice. Hypoparathyroidism.[bestpractice.bmj.com]
  • Etiology Postoperative : ( most common cause of hypoparathyroidism in adults): secondary to thyroidectomy, parathyroidectomy, or radical neck dissection Autoimmune : second most common cause Congenital : Parathyroid aplasia or hypoplasia ( DiGeorge syndrome[amboss.com]
  • In musculoskeletal disorders where a clear etiology is not to be found, it is worthwhile measuring the serum calcium, phosphate and magnesium levels and if necessary, following it up with a parathyroid hormone assay if initial investigations point that[casereports.in]

Epidemiology

  • The Epidemiological Study of Dystonia in Europe (ESDE) Collaborative Group. A prevalence study of primary dystonia in eight European countries. J Neurol 2000 ;247 : 787-792 2. Fahn S. Concept and classification of dystonia.[functionalneurology.com]
  • Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research. J Bone Miner Res. 2011 Oct;26(10):2317-37.[bestpractice.bmj.com]
  • "Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research". J. Bone Miner. Res. 26 (10): 2317–37. doi : 10.1002/jbmr.483. PMC 3405491. PMID 21812031.[en.wikipedia.org]
  • Bilezikian JP, Khan A, Potts JT, Brandi ML, Clarke BL, et al. (2011) Hypoparathyroidism in the adult: Epidemiology, diagnosis, pathophysiology, target?organ involvement, treatment, and challenges for future research. J Bone Miner Res 26: 2317-2337.[omicsonline.org]
  • Epidemiology This is a rare disorder. Found equally in males and females. Age of onset depends on the aetiology. Aetiology Hypoparathyroidism may be transient, congenital/genetically inherited or acquired.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • This highly acclaimed text offers ICU clinicians a new understanding of the pathophysiology of critical illness and new therapeutic approaches to critical care.[books.google.com]
  • Role of the vestibular system in the pathophysiology of spasmodic torticollis. J Neurol Neurosurg Psychiatry 2001 ; 71:285-288 15. Galardi G, Perani D, Grassi F et al.[functionalneurology.com]
  • Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research. J Bone Miner Res. 2011 Oct;26(10):2317-37.[bestpractice.bmj.com]
  • Despite an ever-increasing understanding of the molecular mechanism of parathyroid hormone, its action on skeletal muscle and the pathophysiology of skeletal muscle disorders produced by hyper- and hypoparathyroidism is poorly understood.[medlink.com]
  • Pathophysiology This is a polypeptide hormone produced in the parathyroid gland. These 4 in number and present close to or on the posterior surface of the thyroid gland.[labpedia.net]

Prevention

  • Succinct, targeted coverage of normal childhood growth and development, as well as the diagnosis, management, and prevention of common pediatric diseases and disorders, make this an ideal medical reference book for students, pediatric residents, nurse[books.google.com]
  • Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets[books.google.com]
  • Matuszkiewicz-Rowińska J: KDIGO clinical practice guidelines for the diagnosis, evaluation, prevention, and treatment of mineral and bone disorders in chronic kidney disease. Pol Arch Med Wewn 2010;120:300-306.[karger.com]
  • The awareness of the possible occurrence of impetigo herpetiformis during the puerperium allows early diagnosis, treatment and prevention of maternal complications.[casesjournal.biomedcentral.com]

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