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2016 ; 101
(6
): 2284-99
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Epidemiology and Diagnosis of Hypoparathyroidism
#MMPMID26943720
Clarke BL
; Brown EM
; Collins MT
; Jüppner H
; Lakatos P
; Levine MA
; Mannstadt MM
; Bilezikian JP
; Romanischen AF
; Thakker RV
J Clin Endocrinol Metab
2016[Jun]; 101
(6
): 2284-99
PMID26943720
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CONTEXT: Hypoparathyroidism is a disorder characterized by hypocalcemia due to
insufficient secretion of PTH. Pseudohypoparathyroidism is a less common disorder
due to target organ resistance to PTH. This report summarizes the results of the
findings and recommendations of the Working Group on Epidemiology and Diagnosis
of Hypoparathyroidism. EVIDENCE ACQUISITION: Each contributing author reviewed
the recent published literature regarding epidemiology and diagnosis of
hypoparathyroidism using PubMed and other medical literature search engines.
EVIDENCE SYNTHESIS: The prevalence of hypoparathyroidism is an estimated 37 per
100 000 person-years in the United States and 22 per 100 000 person-years in
Denmark. The incidence in Denmark is approximately 0.8 per 100 000 person-years.
Estimates of prevalence and incidence of hypoparathyroidism are currently lacking
in most other countries. Hypoparathyroidism increases the risk of renal
insufficiency, kidney stones, posterior subcapsular cataracts, and intracerebral
calcifications, but it does not appear to increase overall mortality,
cardiovascular disease, fractures, or malignancy. The diagnosis depends upon
accurate measurement of PTH by second- and third-generation assays. The most
common etiology is postsurgical hypoparathyroidism, followed by autoimmune
disorders and rarely genetic disorders. Even more rare are etiologies including
parathyroid gland infiltration, external radiation treatment, and radioactive
iodine therapy for thyroid disease. Differentiation between these different
etiologies is aided by the clinical presentation, serum biochemistries, and in
some cases, genetic testing. CONCLUSIONS: Hypoparathyroidism is often associated
with complications and comorbidities. It is important for endocrinologists and
other physicians who care for these patients to be aware of recent advances in
the epidemiology, diagnosis, and genetics of this disorder.
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