What Is Hypoparathyroidism? Diagnosing and Treating Children with It



Causes

Hypoparathyroidism occurs when the parathyroid glands in the neck do not produce enough parathyroid hormone (PTH). PTH normally regulates the level of calcium and phosphate in the blood. When PTH levels are low, blood calcium levels drop too low (hypocalcemia). The most common causes of it include the following:

- Damage or removal of the parathyroid glands during neck surgery. About 50% of hypoparathyroidism cases are caused by inadvertent damage or removal of the parathyroid glands during thyroid or parathyroid surgery.

- Autoimmune disease. An autoimmune disorder causes the body's immune system to attack and destroy the parathyroid glands in some cases. This accounts for about 10-20% of it cases.

- Genetic disorders. Rare genetic disorders like DiGeorge syndrome or mutations in certain genes can impair the development of the parathyroid glands. This causes about 5% of cases.

- Idiopathic. In around 25-35% of cases, no specific cause can be identified. This is called idiopathic hypoparathyroidism.

Symptoms

The main symptoms of it result from low calcium levels in the blood and include:

- Tingling or twitching sensations in the fingers, toes, or lips (paresthesia).

- Muscle cramps or spasms.

- Seizures.

- Abnormal sensations around the mouth including a metallic taste.

- Fatigue.

- Depression or moodiness.

- Trouble concentrating.

- Increased thirst and urination if blood calcium dips too low.

Long-term complications of untreated hypoparathyroidism can include cataracts, kidney problems, and irregular heartbeat. Severe or prolonged hypocalcemia can potentially lead to complications in other organs if not treated properly.

Diagnosis

It is diagnosed based on medical history, physical exam, and lab test results. Doctors will check for:

- Low blood calcium level (hypocalcemia). Both ionized and total calcium levels are measured.

- High blood phosphate level (hyperphosphatemia).

- Very low or undetectable PTH levels in the blood.

- Symptoms consistent with hypocalcemia like tingling, muscle cramps, seizures, etc.

Imaging tests like neck ultrasound or thyroid scans may help identify any anatomical abnormalities in the parathyroid glands in some cases. Genetic testing is also available for certain suspected inherited forms.

Treatment

The main goal of it treatment is to maintain normal blood calcium levels through calcium and vitamin D supplementation. The standard treatment involves:

- Calcium supplements. Calcium carbonate or calcium citrate supplements are usually taken multiple times a day with meals to maintain consistent calcium levels.

- Active vitamin D (calcitriol) supplements. Vitamin D helps the body absorb and retain calcium from supplements. This prevents excessive calcium loss from the body.

- Monitoring blood work. Regular blood tests monitor calcium, phosphate, PTH, and vitamin D levels so doses can be adjusted as needed by a doctor.

- Emergency treatment for low calcium levels. If blood calcium drops severely, intravenous calcium may be needed short term along with hospitalization for close monitoring.

- Avoid low-calcium foods. Low-calcium options like soda, high-fiber cereals, and leafy greens should be limited so calcium from supplements is optimally absorbed.

- Lifestyle changes. Stress, illness, or hormonal changes can alter calcium regulation temporarily so doses may need adjusting.

Prognosis and Living with Hypoparathyroidism

With lifelong treatment, it is manageable and most people live normal lifespans. Strict control of calcium levels through medication and diet is important though. Doses often need adjusting throughout life based on changes in kidney function, pregnancy status, developmental stages in children, or surgical events.

Some complications, like cataracts or kidney problems are still possible in longstanding severe cases despite treatment. People with it also require emergency supplies and must seek medical help urgently if calcium levels crash for any reason to prevent dangerous complications. Regular endocrine follow up ensures optimal calcium management. With close medical supervision the disease has minimal impact on quality of life for most people.

Conclusion

In summary, hypoparathyroidism is a disorder of low calcium levels caused by insufficient PTH from the parathyroid glands. It can result from surgery, autoimmune attacks, genetics in some cases, or have no known cause. Symptoms involve abnormal sensations and neurological issues due to low blood calcium levels. Treatment consists of lifelong calcium and vitamin D supplementation which allows people to live normally when managed well under an endocrinologist's guidance. With strict treatment adherence and medical follow up, it has a good long term prognosis in most cases.

 

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About Author:

Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)

*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it

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