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 2199 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 0733 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:
|Medication||Ca||PO4||Ca U||par. %||cramps %|
|Calcium (1462 mg/d)||2.08||1.49||1.67||90||63|
|Vitamine D (11,442 U/d), Ca (1245)||2.12||1.46||2.88||51||43|
|1-Alphacalcidol (2.41 ug/d), Ca (1321)||2.19||1.26||2.65||32||26|
|1-Alphac.(1.26), Vit.D (15,949),Ca (1005)||2.19||1.44||2.65||38||38|
|Calcitriol (0.64 ug/d), Ca (1354)||2.19||1.43||2.52||57||35|
|Calcitr.(0.60), Vit.D (9845), Ca (1133)||2.18||1.34||3.27||48||31|
|Tachysterin (0.73 mg/d)||2.29||1.35||2.52||36||34|
|Tachysterin (0.77), Ca (1292)||2.22||1.43||2.75||67||48|
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.
20 - 23 May 2017
European Society of Endocrinology