Hypoparathyroidism is a disease that occurs as a result of a violation of tissue receptors, or with a deficiency of parathyroid hormone, which regulates the function of phosphorus-calcium metabolism. The disease is rare in 0.3-0.4% of cases; there are no age restrictions for its occurrence.
As a result of a lack of parahormone, there is an increase in phosphate levels and a decrease in blood calcium levels. For this reason, the mineral-alkaline balance is disturbed and the permeability of cell membranes changes. As a result, a person begins to experience great neuromuscular tension, reaching convulsions. Convulsions are very painful, their duration can be from a minute to several hours. They can appear unexpectedly and be accompanied by low or high blood pressure, pallor of the skin, diarrhea, vomiting, and a decreased or increased heart rate.
REASONS FOR THE DEVELOPMENT OF THE DISEASE
Hypoparathyroidism develops mainly with insufficient production of parathyroid gamone by the parathyroid glands. And also hypoparathyroidism can occur as a result of the following factors:
- Deficiency of magnesium in the blood – leads to dysfunction of the parathyroid glands;
- Radiation therapy, for cancers of the neck and head, or treatment of hyperthyroidism with radioactive iodine – has a destructive effect on the parathyroid glands;
- Congenital hypoparathyroidism – this disease is characterized by dysfunction of the thyroid gland, or their absence at all. Sometimes the cause may be insufficient functioning of other glands that produce hormones;
- Acquired hypoparathyroidism is a form of the disease that develops when the parathyroid glands are damaged or surgically removed.
A lowered parathyroid hormone index contributes to a decrease in calcium in blood plasma and bone tissue. Hypoparathyroidism often appears after thyroid surgery (in the postoperative period).
What are the forms of hypoparathyroidism?
There are 3 forms of the course of the disease:
- Hypoparathyroidism in acute farm – characterized by severe and frequent seizures.
- Chronic hypoparathyroidism – attacks are rare, but they can be triggered by many factors: nervous tension, stress, mental trauma, infection and physical exertion. Aggravation occurs in spring and autumn. If the right treatment is selected, frequent and prolonged attacks can be avoided.
- Latent hypoparathyroidism – no visible symptoms. Diagnosis is the only way to identify hypoparathyroidism .
Also, hypoparathyroidism is divided into classes, taking into account the reasons, as a result of which, the disease manifests itself:
- The postoperative period is a consequence of an operation performed on the thyroid gland or neck region;
- Post-traumatic hypoparathyroidism , occurs as a result of exposure to the body of infection or as a result of radiation;
- Congenital hypoparathyroidism – develops as a consequence of the pathology of intrauterine development;
- Idiopathic and autoimmune hypoparathyroidism .
Idiopathic hypoparathyroidism in children develops more often than in adults in conjunction with damage to other glands.
SYMPTOMS OF THE DISEASE
Hypoparathyroidism develops with many symptoms, but seizures are more common.
Hypoparathyroidism in children is manifested by symptoms of laryngospasm with characteristic numbness, muscle spasms, tingling around the mouth, legs, arms.
The symptom of hypoparathyroidism is the hand of the “obstetrician”
Hypoparathyroidism includes 4 groups of syndromes that have the same symptoms and are characterized by a certain state of the body:
- Trophic disorders of tissue nutrition;
- Brain disorders;
- Syndrome of changes in autonomic functions and sensitivity;
- Convulsive, atonic syndrome.
Hypoparathyroidism can also manifest itself in the form of symptoms of autonomic disorders: visual impairment, hearing loss, ringing in the ears, dizziness, fainting, and severe sweating. The sensitivity of the receptors may be disturbed, as a result of this, the perception to loud sounds, sharp sensations of cold and heat, sweet and bitter food increases.
In the chronic form, symptoms of trophic disorders occur: the condition of the skin changes, it becomes dry and begins to peel off; fungal diseases, eczema develop; hair stops growing; dental tissue is damaged, especially in children during the formation of teeth. In adults, caries develops. Hypoparathyroidism in children can cause stunted growth from their peers.
DIAGNOSTICS OF THE DISEASE
Diagnosis of the disease is not particularly difficult, since hypoparathyroidism has characteristic, direct symptoms – first of all, convulsions. The doctor makes the diagnosis based on the history.
Laboratory diagnostics includes studies of blood and urine tests for the presence of parathyroid hormone, P and Ca levels . Hypoparathyroidism is determined by a reduced concentration of parathyroid hormone in the blood plasma, hypophosphaturia , hypocalceuria , hypocalcemia and hyperphosphatemia .
Diagnostics using an X-ray, allows you to identify hypoparathyroidism , the presence of osteosclerosis in a person, calcification of the cartilage of the ribs.
Diagnostics by MRI allows you to identify symptoms, complications of the brain, subcutaneous tissue, deposition of Ca in the internal organs .
To reveal hypoparathyroidism in a latent form, tests with hyperventilation are carried out for an increased determination of convulsive readiness.
DISEASE TREATMENT
Treatment for an acute attack of hypoparathyroidism is carried out in a hospital. The patient is injected intravenously with a calcium gluconate solution or calcitriol preparations . Treatment is prescribed with sedatives and antispasmodics. These include:
- Phenobarbital, relanium ;
- Papaverine, no-shpa.
Chronic hypoparathyroidism , during treatment, requires the inclusion of a daily dietary diet. It should include foods poor in phosphorus, but rich in calcium, as well as containing vitamin D, these include:
- Cauliflower;
- Rosehip;
- Fish liver;
- Egg yolk.
Due to the content of phosphorus in almost all products, aluminum hydroxide is shown to reduce its absorption, it binds the element in the intestine. They also prescribe preparations containing vitamin D and calcium.
Hypoparathyroidism has recently been treated with surgery. Treatment consists of parathyroid transplantation. Surgical treatment of the disease, with a deficiency of hormones in the thyroid and parathyroid glands, in the postoperative period, is prescribed as a result of the following indicators:
- With low levels of serum calcium and parathyroid hormone;
- With autoimmune, congenital forms of hypoparathyroidism , the postoperative period, when conventional methods of treatment are powerless.
Hypoparathyroidism is a serious disease, and in order for the prognosis for life to be favorable, you need to be under the constant supervision of an endocrinologist, who will keep the course of the disease under control and carry out therapy once every 3 months. It is also necessary to undergo an examination by an ophthalmologist once every 6 months and do a tomography of the brain.