Introduction: Postoperative hypoparathyroidism is a rare, but complex endocrine disorder. The purpose of this study was to evaluate the symptoms, signs and sequelae of the disease in a major patient group in the post-Chernobyl era using a new questionnaire instrument.
Methods: A random sample of 25 patients with symptomatic permanent hypoparathyroidism was chosen out of a group of 158. The patients underwent physical examination, determination of parathyroid hormone and calcium levels in serum and had their signs, symptoms and sequelae of disease systematically assessed by a validated specific questionnaire developed by us. Scores for illnes severity were calculated. Local Ethical Committee approval has been obtained.
Results: The patients were aged 38.0 plus/minus 15.3 years (range 15 - 68). Parathyroid hormone of all patients was on average 14.12 plus/minus 8.08 picograms per mililitre, total calcium - 1.94 plus/minus 0.26 milimol per litre, ionised calcium - 0.92 plus/minus 0.19 milimol per litre. Most frequent symptoms (>50 % of all patients) were muscle pain, joint pain, cold sensations in hands and feet, impairment of sexuality, paresthesia, abdominal cramps, sleeping disorders, brittle nails and dyspnea on exercise. Most frequent findings (>50 % of all patients) were dry skin, hair loss, enamel defects and oedemas. Also, patients had kidney stones (44 %), bone alterations (44 %), cataracts (20 %) and basal ganglia calcification (16 %). Specific hypocalciemia signs were positive: Chvostek's (60 %), Trousseau's (56 %) and Lust's (36 %).
Conclusions: We examined systematically a large patient group with heavy permanent postoperative hypoparathyroidism using a special questionnaire instrument. Hereby it was possible to evaluate and analyse the fequency of signs, symptoms and sequelae of disease. The application of the instrument as simple and cheap method can be recommended for general screening of patients with suspected or proven postoperative hypoparathyroidism and the degree of disease estimated.
03 - 05 Nov 2003
Society for Endocrinology