Improving management of severe hypoparathyroidism: a case series View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-10-13

AUTHORS

Beatriz Ugalde-Abiega, Cristina Lamas Oliveira, José Joaquín Alfaro Martínez, Olalla Meizoso-Pita, Cristina Sevillano Collantes, Inés Gomez García, Ana Perez Rodríguez, Isabel Huguet

ABSTRACT

Introduction Hypoparathyroidism is considered a rare endocrine disease. Despite being a deficiency of parathyroid hormone, the standard therapy is based on oral calcium and active vitamin D supplementation. This approach provides satisfactory management in most cases but may be inadequate for patients in the most complex spectrum of the disease. Other therapies are being explored, and among them, the use of recombinant human parathyroid hormone (PTH) has proved to decrease the requirements of calcium and active vitamin D to reach adequate therapeutic goals.ObjectiveWe aimed to provide information on the effectiveness of the current recombinant parathyroid hormone analogs in the clinical management of difficult to control cases of hypoparathyroidism.Method and materialsWe report our experience using teriparatide and PTH (1–84) through five complex cases of hypoparathyroidism of diverse etiologies. We describe each case and report the effectiveness of treatment in clinical practice.ResultsFour patients with postsurgical hypoparathyroidism and one patient with autoimmune hypoparathyroidism, all of them with suboptimal control under the standard treatment with calcium and calcitriol supplements or calcium gluconate infusion, are presented. They were all started on teriparatide or PTH (1–84), and all of them showed a diminishment of symptoms and were able to maintain normocalcemia without parenteral calcium despite a reduction of oral treatment.ConclusionThis article highlights the effectiveness and safety of hormonal replacement treatment in difficult to manage hypoparathyroidism and provides evidence which justifies its off-label prescription in the case of teriparatide. We consider that this treatment should be considered in cases in which standard treatment fails to reach adequate therapeutic goals. More... »

PAGES

71-77

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s42000-021-00326-x

DOI

http://dx.doi.org/10.1007/s42000-021-00326-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1141850350

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34647284


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