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Endocrine Abstracts (2017) 49 S1.2 | DOI: 10.1530/endoabs.49.S1.2

Uk.


Hypoparathyroidism is characterized by absent or low circulating concentrations of parathyroid hormone (PTH), which results in hypocalcaemia, hyperphosphataemia and impaired renal reabsorption of calcium. Hypoparathyroidism has a prevalence of ~20–40 cases per 100 000 individuals, and anterior neck surgery accounts for around 75% of cases. Postsurgical hypoparathyroidism may arise in patients undergoing total thyroidectomy, radical neck dissection for head and neck malignancies, and after total parathyroidectomy. Hypoparathyroidism following surgery is caused by intraoperative trauma, and inadvertent gland removal or devascularisation. Transient postsurgical hypoparathyroidism, defined as lasting <6 months, affects 25–30% of patients following total thyroidectomy; whilst permanent postsurgical hypoparathyroidism, defined as lasting >6 months, affects up to 3% of patients after total thyroidectomy. Decreases in pre-operative serum calcium and 25-hydroxyvitamin D concentrations, reduced intraoperative PTH concentrations, and longer duration of surgery represent independent predictors of transient hypoparathyroidism. Permanent hypoparathyroidism following thyroid surgery is associated with: inability to identify ≥2 parathyroid glands during surgery; hypocalcaemia at 24-h post-surgery; and reoperation for bleeding. Occasionally, postsurgical hypoparathyroidism may have a delayed-onset and present several years after neck surgery. Autoimmune-mediated destruction of the parathyroids represents the next most common cause of acquired hypoparathyroidism and is considered in patients with a personal or family history of autoimmune diseases. Autoimmune acquired hypoparathyroidism may be associated with the presence of anti-parathyroid gland antibodies, and some patients harbor antibodies against the calcium-sensing receptor (CaSR). Acquired hypoparathyroidism may also be caused by hypomagnesaemia, which impairs PTH secretion; and can rarely be due to exposure to ionizing radiation, or result from infiltrative diseases affecting the parathyroids such as metastases or iron/copper overload.

Volume 49

19th European Congress of Endocrinology

Lisbon, Portugal
20 May 2017 - 23 May 2017

European Society of Endocrinology 

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