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Improving management of severe hypoparathyroidism: a case series

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A Correction to this article was published on 01 December 2021

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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.

Objective

We 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 materials

We 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.

Results

Four 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.

Conclusion

This 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.

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Authors and Affiliations

  1. Hospital Universitario Infanta Leonor, Avda Gran Vía del Este, 80. 28031, Madrid, Spain

    Beatriz Ugalde-Abiega, Olalla Meizoso-Pita, Cristina Sevillano Collantes & Isabel Huguet

  2. Complejo Hospitalario Universitario Albacete, Albacete, Spain

    Cristina Lamas Oliveira, José Joaquín Alfaro Martínez & Ana Perez Rodríguez

  3. Hospital Mancha Centro de Alcázar de San Juan, Alcázar de San Juan, Spain

    Inés Gomez García

Authors
  1. Beatriz Ugalde-Abiega
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  2. Cristina Lamas Oliveira
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Correspondence to Beatriz Ugalde-Abiega.

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Ugalde-Abiega, B., Lamas Oliveira, C., Alfaro Martínez, J.J. et al. Improving management of severe hypoparathyroidism: a case series. Hormones 21, 71–77 (2022). https://doi.org/10.1007/s42000-021-00326-x

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  • DOI: https://doi.org/10.1007/s42000-021-00326-x

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