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Vol 74, No 5 (2023)
Guidelines / Expert consensus
Submitted: 2023-08-13
Accepted: 2023-08-16
Published online: 2023-10-23
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Polski

Management of hypoparathyroidism: a Position Statement of the Expert Group of the Polish Society of Endocrinology

Waldemar Misiorowski1, Marek Dedecjus2, Jerzy Konstantynowicz3, Arkadiusz Zygmunt4, Beata Kos-Kudła5, Andrzej Lewiński6, Marek Ruchała7, Wojciech Zgliczyński1
DOI: 10.5603/ep.96950
·
Pubmed: 37902011
·
Endokrynol Pol 2023;74(5):447-467.
Affiliations
  1. Department of Endocrinology, Medical Centre of Postgraduate Medical Education, Bielanski Hospital, Warsaw, Poland
  2. Department of Oncologic Endocrinology and Nuclear Medicine, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
  3. Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Białystok, Poland
  4. Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Łódź, Poland
  5. Department of Endocrinology and Neuroendocrine Neoplasms, Chair of Pathophysiology and Endocrinology, Medical University of Silesia, Katowice, Poland
  6. Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland
  7. Department of Endocrinology, Metabolism and Internal Medicine, Medical University of Poznan, Poznań, Poland

open access

Vol 74, No 5 (2023)
Guidelines
Submitted: 2023-08-13
Accepted: 2023-08-16
Published online: 2023-10-23

Abstract

Over the past few years, there have been significant advances in our understanding of hypoparathyroidism (HypoPT) in terms of its epidemiology, clinical presentation, etiology, and skeletal and renal complications. Moreover, the available treatment options for HypoPT have changed. This position statement of the Expert Group of the Polish Society of Endocrinology summarizes the current state of knowledge and provides recommendations for optimal management to assist clinicians in the diagnosis, treatment, and monitoring of HypoPT in Poland. The specific aspects of HypoPT management in children, pregnant and lactating women, and patients with chronic kidney disease are also discussed.

HypoPT is a rare disorder characterized by hypocalcemia and the lack or deficiency of parathyroid hormone (PTH). Hypoparathyroidism can be associated with complications, including nephrocalcinosis, nephrolithiasis, renal insufficiency, cataract, seizures, cardiac arrhythmia, depression, and an increased risk of infection. Minimizing complications of HypoPT requires careful evaluation and close monitoring of laboratory parameters. Conventional management of HypoPT has focused on maintaining serum calcium levels using oral calcium and active vitamin D. However, this approach is limited because it does not restore normal PTH function, is often associated with inadequate biochemical control, and raises concerns as to long-term side effects. HypoPT is the only classic endocrine insufficiency that is not commonly treated with the substitution of the missing hormone. Recently, recombinant human PTH(1-84) has become available, offering hope that the use of the missing hormone in the treatment of HypoPT will help achieve better control and reduce the risk of complications. However, this treatment is currently unavailable in Poland.

Abstract

Over the past few years, there have been significant advances in our understanding of hypoparathyroidism (HypoPT) in terms of its epidemiology, clinical presentation, etiology, and skeletal and renal complications. Moreover, the available treatment options for HypoPT have changed. This position statement of the Expert Group of the Polish Society of Endocrinology summarizes the current state of knowledge and provides recommendations for optimal management to assist clinicians in the diagnosis, treatment, and monitoring of HypoPT in Poland. The specific aspects of HypoPT management in children, pregnant and lactating women, and patients with chronic kidney disease are also discussed.

HypoPT is a rare disorder characterized by hypocalcemia and the lack or deficiency of parathyroid hormone (PTH). Hypoparathyroidism can be associated with complications, including nephrocalcinosis, nephrolithiasis, renal insufficiency, cataract, seizures, cardiac arrhythmia, depression, and an increased risk of infection. Minimizing complications of HypoPT requires careful evaluation and close monitoring of laboratory parameters. Conventional management of HypoPT has focused on maintaining serum calcium levels using oral calcium and active vitamin D. However, this approach is limited because it does not restore normal PTH function, is often associated with inadequate biochemical control, and raises concerns as to long-term side effects. HypoPT is the only classic endocrine insufficiency that is not commonly treated with the substitution of the missing hormone. Recently, recombinant human PTH(1-84) has become available, offering hope that the use of the missing hormone in the treatment of HypoPT will help achieve better control and reduce the risk of complications. However, this treatment is currently unavailable in Poland.

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Keywords

calcium; disorders of calcium/phosphate metabolism; hypoparathyroidism; parathyroid hormone; parathyroid-related disorders; phosphate 

About this article
Title

Management of hypoparathyroidism: a Position Statement of the Expert Group of the Polish Society of Endocrinology

Journal

Endokrynologia Polska

Issue

Vol 74, No 5 (2023)

Article type

Guidelines / Expert consensus

Pages

447-467

Published online

2023-10-23

Page views

1004

Article views/downloads

3247

DOI

10.5603/ep.96950

Pubmed

37902011

Bibliographic record

Endokrynol Pol 2023;74(5):447-467.

Keywords

calcium
disorders of calcium/phosphate metabolism
hypoparathyroidism
parathyroid hormone
parathyroid-related disorders
phosphate 

Authors

Waldemar Misiorowski
Marek Dedecjus
Jerzy Konstantynowicz
Arkadiusz Zygmunt
Beata Kos-Kudła
Andrzej Lewiński
Marek Ruchała
Wojciech Zgliczyński

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