Endocrine Abstracts (2017) 49 OC10.1 | DOI: 10.1530/endoabs.49.OC10.1

Treatment of 711 patients with hypoparathyroidism: a retrospective study in 3 German endocrine centres

Martin Grussendorf1, Bettina Stamm2, Niklas Stamm3,4 & Heide Siggelkow4,5

1Endocrine Centre, Stuttgart, Germany; 2MVZ Endokrinologikum, Saarbrücken, Germany; 3Endocrinology and Metabolism, University Medicine, Mainz, Germany; 4Clinic of Gastroenterology and Gastrointestinal Oncology, University Medical Center, Göttingen, Germany; 5MVZ Endokrinologikum, Göttingen, Germany.

Care of patients (pts.) with hypoparathyroidism (HypoPT) is a challenge, because pts. are usually not treated with the absent hormone, but with several forms of vitamine D. We retrospectively evaluated the data of pts. with HypoPT in three endocrine centres in Germany.

Methods: Records of 711 pts. with HypoPT (Centre 1 (C1): n=381, C2: n=253, C3: n=77) were reviewed (female: 592, male: 119). The following data under treatment (time range 2–199 months) were evaluated: medication, Calcium (Ca) – values, tingling sensations (paresthesia), and cramps.

Results: Of these 711 pts. 29 had idiopathic HypoPT, 10 HypoPT after parathyroidectomy, 669 after thyroid operation (Tx): subtotal Tx: 471, HemiTx: 12, totalTx: 186 pts. Age of pts. at first visit (V1): 49.85 years (mean), time between Tx and V1: 76.85 months (mean, range 0–733 months). Mean values of Ca (mmol/l), PO4 (mg/dl) in serum, Ca in urine (Ca U; mmol/24 h); % of patients with paresthesia (par.) and cramps under different therapies (mean daily dose in brackets) as follows:

MedicationCaPO4Ca Upar. %cramps %
Calcium (1462 mg/d)2.081.491.679063
Vitamine D (11,442 U/d), Ca (1245)2.121.462.885143
1-Alphacalcidol (2.41 ug/d), Ca (1321)
1-Alphac.(1.26), Vit.D (15,949),Ca (1005)2.191.442.653838
Calcitriol (0.64 ug/d), Ca (1354)2.191.432.525735
Calcitr.(0.60), Vit.D (9845), Ca (1133)2.181.343.274831
Tachysterin (0.73 mg/d)2.291.352.523634
Tachysterin (0.77), Ca (1292)2.221.432.756748

Conclusion: As expected monotherapy with high doses of calcium was not sufficient. The combination of 1-Alphacalcidol and Calcium was the best regimen for treating HypoPT and improving complaints. Further correlations between different treatment regimen and parameters of renal and bone metabolism will be calculated.

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