Treatment of severe idiopathic hypoparathyroidism: a case report
Abstract
Hypoparathyroidism is a rare disorder characterized by parathyroid hormone (PTH) insufficiency, the development of hypocalcemia and alteration of bone tissue remodeling.
The goal of treatment is to normalize the indicators of calcium-phosphorus metabolism and leveling of clinical manifestations. Standard treatment of hypoparathyroidism consists of oral calcium and active forms of vitamin D, in doses necessary to maintain calcium levels at the lower limit of the reference interval.
Nevertheless, treatment of the disease exerts certain difficulties in clinical practice. At the same time, compensation of the hypoparathyroidism is necessary to prevent ectopic calcification. Daily subcutaneous delivery of PTH (1–84) and PTH (1–34) has emerged as a promising therapeutic tool. However, its use should be restricted to patients insufficiently controlled with the standard treatment with active vitamin D and calcium.
We present a clinical case of idiopathic hypoparathyroidism with severe clinical presentation of hypocalcaemia and ectopic calcification. Idiopathic hypoparathyroidism is a consequence of autoimmune destruction of the parathyroid glands and is exhibited by excluding all known causes of hypoparathyroidism.
PTH (1–34) treatment allowed reducing the dose of calcium and vitamin D and achieving compensation of the disease.
About the Authors
Diliara Sh. UmiarovaEndocrinology Research Centre
Russian Federation
resident
Tatiana A. Grebennikova
Endocrinology Research Centre
Russian Federation
MD
Natalya V. Tarbaeva
Endocrinology Research Centre
Russian Federation
MD, PhD
Zhanna E. Belaya
Endocrinology Research Centre
Russian Federation
MD, PhD, Professor
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3. Fig. 1. MSCT of the brain. Note: Farah syndrome is a calcification of the basal ganglia (right) and nerve fibers (left). | |
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4. Fig. 2. Dynamics of calcium levels on the background of the treatment | |
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For citations:
Umiarova D.Sh., Grebennikova T.A., Tarbaeva N.V., Belaya Zh.E. Treatment of severe idiopathic hypoparathyroidism: a case report. Osteoporosis and Bone Diseases. 2018;21(2):36-40. (In Russ.)
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