Materiały źródłowe

• #1 Nursing Care Plan (NCP) for Hypoparathyroidism | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-ncp-for-hypoparathyroidism

  This care plan aims to guide nursing professionals in managing patients with hypoparathyroidism, focusing on understanding the condition, identifying symptoms, and implementing appropriate interventions to manage complications and maintain electrolyte balance. […] Maintenance of calcium and phosphorus levels within normal range. […] Prevention of complications associated with hypocalcemia, such as tetany (muscle cramps and spasms) and seizures. […] Patient education about disease management, including diet and medication adherence. […] Effective coping with the condition and its symptoms. […] Assessment of Neuromuscular Irritability: Monitor for signs of tetany, muscle cramps, and spasms. […] Calcium and Phosphorus Level Monitoring: Regularly check serum calcium and phosphorus levels.

• #2 Hypoparathyroidism – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoparathyroidism/symptoms-causes/syc-20355375

  Hypoparathyroidism is an uncommon condition in which the body produces abnormally low levels of parathyroid hormone (PTH). parathyroid hormone (PTH) is key to regulating and maintaining a balance of two minerals in the body calcium and phosphorus. […] Supplements to bring calcium and phosphorus levels into a normal range treat the condition. Depending on the cause of hypoparathyroidism, you’ll likely need to take supplements for life. Sometimes parathyroid hormone replacement is needed if supplements alone are not enough to bring levels into a normal range. […] If you have signs or symptoms associated with hypoparathyroidism, see your health care provider for an evaluation. Contact your health care provider immediately if you have a seizure or have difficulty breathing. These can both be complications of hypoparathyroidism.

• #2 Nursing Care Plan (NCP) for Hypoparathyroidism | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-ncp-for-hypoparathyroidism

  Cardiac assessment: ECG and auscultation for changes. […] Mental Status Assessment: For changes due to low calcium levels, such as irritability or depression. […] Risk for Injury related to neuromuscular irritability due to hypocalcemia. […] Imbalanced Nutrition: Less Than Body Requirements related to restrictions and dietary changes. […] Deficient Knowledge regarding disease process and management. […] Anxiety related to symptom occurrence and management. […] Electrolyte Monitoring and Management: Regularly monitor serum calcium and phosphorus levels and administer supplements as prescribed. […] Rationale: Maintaining electrolyte balance is crucial in preventing symptoms and complications of hypoparathyroidism. […] Pain Management: Administer calcium and magnesium as ordered and use non-pharmacological methods to relieve muscle cramps.

• #3 Standards of care for hypoparathyroidism in adults: a Canadian and International Consensus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6365672/

  Purpose: To provide practice recommendations for the diagnosis and management of hypoparathyroidism in adults. […] Hypoparathyroidism is a rare disease characterized by hypocalcemia, hyperphosphatemia and a low or inappropriately normal serum parathyroid hormone level (PTH). […] Treatment requires close monitoring as well as patient education. […] Conventional therapy with calcium supplements and active vitamin D analogs is effective in improving serum calcium as well as in controlling the symptoms of hypocalcemia. […] This manuscript addresses acute and chronic management of hypoparathyroidism in adults. […] Hypoparathyroidism requires careful evaluation and pharmacologic intervention in order to improve serum calcium and control the symptoms of hypocalcemia. Frequent laboratory monitoring of the biochemical profile and patient education is essential to achieving optimal control of serum calcium.

• #3 Nursing Care Plan (NCP) for Hypoparathyroidism | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-ncp-for-hypoparathyroidism

  Rationale: Adequate mineral supplementation and pain management improve comfort and prevent tetany. […] Anxiety Reduction: Provide emotional support and counseling referrals as needed. […] Rationale: Emotional support helps in coping with the stress of managing a chronic condition. […] Patient Education: Educate about the importance of medication adherence, dietary modifications, and recognizing symptoms of hypocalcemia. […] Rationale: Informed patients are more likely to adhere to treatment and recognize when to seek medical attention. […] Monitoring for Complications: Be vigilant for signs of complications like kidney stones and cardiac arrhythmias. […] Rationale: Early detection and intervention can prevent serious complications. […] This care plan provides a structured approach to managing a patient with hypoparathyroidism, emphasizing the maintenance of electrolyte balance, prevention of complications, patient education, and emotional support. Tailoring these interventions to individual patient needs is crucial for effective management and improved quality.

• #4 Hypoparathyroidism Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/hypoparathyroidism

  Your health care provider will check for muscle spasms, twitching, and seizures and examine your skin for problems, such as dry skin, thinning hair, and fungal infections. […] The main treatment for hypoparathyroidism is aimed at restoring the levels of calcium in the body. If you have hypoparathyroidism, you will probably have to take calcium and vitamin D (which is required for the body to absorb calcium) supplements for the rest of your life. […] It is important to get regular checkups so your doctor can monitor the levels of calcium and phosphorus in your blood over time. […] People with hypoparathyroidism require lifelong monitoring by a health care provider.

• #4 Hypoparathyroidism NCLEX Review

  https://www.registerednursern.com/hypoparathyroidism-nclex-review/

  As the nurse taking care of the patient with hypoparathyroidism it is important you understand the signs and symptoms, pathophysiology, causes, nursing interventions, and medical treatments. […] Nursing Interventions for Hypoparathyroidism: Monitor calcium (normal 8.6 to 10.0 mg/dL) and phosphate levels (normal 2.7 to 4.5 mg/dL). […] Ensure patient eats a diet high in calcium (dairy, green leafy vegetables) and low in phosphate (organ meats, soft drinks, eggs). […] Administering Medications per physicians order: Goal of medications are to increase calcium levels and decrease phosphate levels. […] Parathyroid Hormone Replacement: Natpara. […] Monitor calcium levels: can increase calcium levels too high, GI issues nausea vomiting, paresthesia.

• #5 Standards of care for hypoparathyroidism in adults: a Canadian and International Consensus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6365672/

  Laboratory testing should confirm a low albumin-corrected total serum calcium level or a low ionized calcium levels and low PTH on at least two occasions. […] The diagnosis of hypoparathyroidism is made in the presence of low serum calcium (ionized or adjusted for albumin) and low or inappropriately normal PTH confirmed on two separate occasions. […] The risk for and extent of renal complications are assessed by evaluating renal function (eGFR), a 24-h urine for calcium excretion, and a renal ultrasound for the presence of nephrocalcinosis or nephrolithiasis. […] In hypoparathyroidism, long-term renal complications and extraskeletal calcification are commonly seen and may be reduced by lowering urine calcium excretion, serum phosphorus and the calcium-phosphate product. […] Acute severe hypocalcemia is treated with IV calcium boluses followed by a continuous calcium infusion as well as oral calcium supplements and active vitamin D.

• #5 Hypoparathyroidism – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoparathyroidism/diagnosis-treatment/drc-20355381

  The U.S. Food and Drug Administration (FDA) has approved parathyroid hormone (Natpara) for low blood calcium due to hypoparathyroidism. […] Your health care provider might recommend that you consult a registered dietitian, who is likely to advise a diet that’s: Rich in calcium. […] This means avoiding carbonated soft drinks, which contain phosphorus in the form of phosphoric acid, and limiting processed foods, meats, hard cheeses, nuts and whole grains. […] If you need immediate symptom relief, you may need to stay in the hospital so that you can receive calcium by a small tube in a vein in your hand or arm (intravenously). […] Your health care provider will regularly check your blood to monitor levels of calcium and phosphorus. […] Because hypoparathyroidism is usually a long-lasting disorder, testing and treatment generally is lifelong.

• #5 Hypoparathyroidism – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoparathyroidism/diagnosis-treatment/drc-20355381

  To diagnose hypoparathyroidism, your health care provider will discuss your medical history and do a physical exam, and may suggest blood and urine tests. […] The goal of treatment is to relieve symptoms and to bring calcium and phosphorus levels in your body back into a standard range. […] Treatment usually includes: Oral calcium supplements as tablets, chews or liquid can increase calcium levels in your blood. […] High doses of vitamin D, generally in the form of calcitriol, can help your body absorb calcium and eliminate phosphorus. […] If your magnesium level is low and you’re experiencing symptoms of hypoparathyroidism, you may need to take a magnesium supplement. […] If your calcium levels remain low even with treatment, or if the amount of calcium in your urine is very high, thiazide diuretics can help decrease the amount of calcium lost through your urine.

• #6 Med-Surg Nursing: Hypoparathyroidism vs. Hyperparathyroidism

  https://leveluprn.com/blogs/medical-surgical-nursing/endocrine-system-17-hypoparathyroidism-hyperparathyroidism?srsltid=AfmBOooHwwnGdylykqUlW5F23a8I-TnyqZeqDG0NQpUZXCII56dMXfp-

  Hypoparathyroidism is decreased or insufficient secretion of PTH. Since PTHs main function is to increase calcium levels in the body, when the parathyroid glands are functioning normally, calcium will be at the correct level. When PTH is too low, blood calcium levels will also be low. […] The signs and symptoms of hypoparathyroidism are the signs and symptoms of hypocalcemia (low calcium levels), which include numbness, tingling around the mouth, muscle twitching, GI upset, and positive Chvosteks and Trousseaus signs. Hypocalcemia can result in more severe side effects too, like seizures, dysrhythmias, and tetany. […] When you have a patient with hypoparathyroidism, you may need to implement seizure precautions because of the risk of seizures associated with hypocalcemia. You will follow your facilitys procedure, but that usually includes padding the side-rails of the bed and making sure oxygen equipment is available. […] A patient with hypoparathyroidism will need a high-calcium, low-phosphorus diet, and can be given their phosphate binders with their meals.

• #7 Hypoparathyroidism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441899/

  Long-term PTH deficiency treatment also involves supplementation with calcium and vitamin D to keep serum calcium levels at 8 to 9 mg/dL. […] Patients with hypoparathyroidism must be educated about the importance of compliance in taking calcium and calcitriol supplements and the need for periodic monitoring of calcium, phosphorus, and renal function biochemical studies. […] The medical management of hypoparathyroidism is done by an interprofessional team that consists of an emergency department physician, endocrinologist, surgeon, and primary care provider.

• #7 Hypoparathyroidism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441899/

  Hypoparathyroidism treatment primarily consists of correcting calcium, vitamin D, and magnesium deficiencies with supplementation. […] This activity for healthcare professionals is designed to enhance the learner’s competence when managing hypoparathyroidism, equipping them with updated knowledge, skills, and strategies for timely diagnosis, effective interventions, and improved care coordination, leading to better patient outcomes. […] Hypoparathyroidism is typically diagnosed with laboratory studies confirming a low corrected calcium level as well as a decreased or undetectable parathyroid hormone level. […] In stable patients diagnosed with hypoparathyroidism after neck surgeries (eg, thyroidectomy), the recommended standard treatment is oral elemental calcium 2 to 3 g and calcitriol .5 to 1.5 g daily.

• #8 Treatment Plan for Hypoparathyroidism | Hypoparathyroidism NewsEnvelope icon

  https://hypoparathyroidismnews.com/health-insights/treatment-plan-for-hypoparathyroidism/

  If you or your child has hypoparathyroidism — which can have causes ranging from genetic mutations or surgery to high levels of magnesium — it is important to create a treatment plan, together with your healthcare team. […] Having such a plan in place will ensure that you or your child receive the best possible medical care. […] A treatment plan for hypoparathyroidism is a working document that contains detailed information about the disease and a list of its common symptoms — notably any that you or your child experience. […] The plan also should include a list of medications or supplements that you take, when you take them, and the possible side effects. […] A treatment plan can ensure that you or your child are receiving appropriate care. […] Having the treatment plan available can improve your or your child’s care, since it will guide your healthcare team in treating any other illnesses or injuries you may have.

• #9 01.10 Hypoparathyroidism | Free NURSING.com Courses

  https://nursing.com/lesson/01-10-hypoparathyroidism

  Hypoparathyroidism = less PTH […] Not enough PTH […] Decreased calcium levels increased nerve excitability tetany (muscle spasms) […] Increased phosphorus levels […] Calcium supplements […] Vitamin D supplements […] Cardiac monitoring watch rhythm […] Anti-epileptic medications […] Hormone Regulation low parathyroid hormone levels (PTH) […] Nutrition low calcium need food high in […] High Phosphorus need food low in […] Patient Education choose foods carefully […] Eat foods rich in calcium […] Limit phosphorus rich food […] Follow up blood tests twice per year […] Hypoparathyroidism involves underactive parathyroid glands which results in low PTH. […] Less PTH means less calcium in the blood, resulting in increased nerve excitability. […] This can cause seizures, tetany or muscle spasms, and heart arrhythmias. […] Hypoparathyroidism is managed with Calcium and vitamin D supplements, anti-seizure medications, and PTH lab work as ordered by the doctor. […] We should encourage our patients to eat foods high in calcium like dairy and green leafy veggies, and eat foods low in phosphorus like meat.

• #10 Hypoparathyroidism Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/122207-treatment

  Treatment of patients with hypoparathyroidism involves correcting the hypocalcemia by administering calcium and vitamin D. […] An endocrinologist should be involved in the care of all patients who have primary hypoparathyroidism or who are at risk of developing it. […] A diet rich in calcium content (ie, emphasizing dairy products) is recommended for patients with primary hypoparathyroidism. […] Patients with symptomatic hypocalcemia develop tetany. Otherwise, no restriction in activity for these patients is necessary.

• #11 Hypoparathyroidism: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22672-hypoparathyroidism

  Hypoparathyroidism is a rare but treatable condition that causes low levels of calcium in your blood. Its usually treated with calcium and vitamin D supplements. […] The goal of treatment for hypoparathyroidism is to minimize symptoms and correct the amount of calcium and minerals in your body. […] Treatment can include: Taking calcium carbonate and vitamin D supplements: Most people with hypoparathyroidism have to take calcium and vitamin D supplements for life. Its the go-to treatment option for hypoparathyroidism. […] If taking calcium and vitamin D supplements isnt working to treat your hypoparathyroidism, your provider might have you take parathyroid hormone injections. […] If a person with hypoparathyroidism has too much vitamin D and calcium as a part of their treatment, it can cause a high level of blood calcium (hypercalcemia), which can be harmful to your health.

• #12 Treatments for HypoPT

  https://www.webmd.com/women/hypoparathyroidism-treatment-plan

  Thiazide diuretics. Sometimes your calcium levels will still be low even if you take calcium supplements or use other treatments for hypoparathyroidism. […] Magnesium supplements. If you have low magnesium levels with hypoparathyroidism, talk to your doctor about a magnesium supplement. […] Palopegteriparatide (Yorvipath) injections. Palopegteriparatide, which is a synthetic form of the human parathyroid hormone, was approved by the FDA to treat hypoparathyroidism in adults. […] Intravenous infusion. This treatment can help with symptom relief right away. […] A special diet. Your doctor might also suggest that you use food as medicine. […] Your dietitian will also want you to eat a diet that’s low in phosphorus. […] As with all things, there can be a risk involved with some of the treatment options for hypoparathyroidism.

• #12 Treatments for HypoPT

  https://www.webmd.com/women/hypoparathyroidism-treatment-plan

  If you were recently diagnosed with hypoparathyroidism, youll want to learn more about each treatment option for the condition. You can aim to live a healthy life with a good treatment plan. With your care program, your doctor will aim to ease your symptoms and bring your phosphorus and calcium levels back to normal. […] While hypoparathyroidism is a lifelong condition, many people are able to control their symptoms with the right treatment. […] Your hypoparathyroidism care plan might include: […] Calcium supplements. Your doctor might have you take calcium supplements in a tablet, a liquid, or a chewable form. This can help boost the calcium levels in your blood and help with your hypoparathyroidism. […] Vitamin D. This vitamin can help your body absorb calcium and get rid of phosphorus.

• #13 Hypoparathyroidism: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000385.htm

  Hypoparathyroidism is a disorder in which the parathyroid glands in the neck do not produce enough parathyroid hormone (PTH). […] The goal of treatment is to reduce symptoms and restore the calcium and mineral balance in the body. Treatment involves calcium carbonate and vitamin D supplements. These usually must be taken for life. Blood levels are measured regularly to make sure that the dose is correct. A high-calcium, low-phosphorous diet is recommended. […] People who have life-threatening attacks of low calcium levels or prolonged muscle contractions are given calcium through a vein (IV). Precautions are taken to prevent seizures or larynx spasms. Your heart is monitored for abnormal rhythms until you are stable. When the life-threatening attack has been controlled, treatment continues with medicine taken by mouth.

• #14 Management of hypoparathyroidism: a Position Statement of the Expert Group of the Polish Society of Endocrinology | Misiorowski | Endokrynologia Polska

  https://journals.viamedica.pl/endokrynologia_polska/article/view/96950?locale=en_US

  The management of symptomatic hypocalcemia requires urgent intravenous calcium administration, and in most cases, continued treatment with calcium by slow intravenous infusion. […] Once the severe symptoms of tetany resolve, oral calcium preparations should be introduced in previously untreated patients, and calcitriol or any other active vitamin D metabolite should be considered. […] In previously treated patients, the causes of acute hypocalcemia should be assessed and existing therapy should be modified accordingly. […] The conventional treatment of HypoPT includes oral calcium supplementation and a judicious use of active vitamin D (i.e., calcitriol or another active analogue) at individualized doses, depending on clinical assessment. […] The frequency of monitoring of serum calcium, phosphate, and other parameters such as magnesium is very much a function of the extent to which a patient is stable on a given dosing regimen.

• #15 Management of hypoparathyroidism: a Position Statement of the Expert Group of the Polish Society of Endocrinology | Misiorowski | Endokrynologia Polska

  https://journals.viamedica.pl/endokrynologia_polska/article/view/96950?locale=en_US

  The first-line treatment includes oral calcium supplementation and active vitamin D (e.g., calcitriol) administered at individualized doses based on clinical and laboratory assessment. […] The treatment of neonates, infants, and children with HypoPT aims to maintain normal calcium and phosphate levels and to prevent severe symptoms associated with hypocalcemia (seizures, tetany, neuropsychiatric disorders) and hyperphosphatemia. […] The first-line treatment includes oral calcium supplementation and active forms of vitamin D (calcitriol) at individualized doses based on clinical and laboratory evaluation. […] In patients with hypercalciuria, thiazide diuretics may be helpful. […] The need for independent vitamin D3 supplementation is also emphasized. […] The aims of chronic treatment of HypoPT are as follows: to prevent symptoms of hypocalcemia; to maintain serum calcium levels slightly below normal; to maintain fasting serum phosphate concentrations within the high normal range or only slightly elevated; to avoid hypercalcemia; to avoid hypercalciuria; to maintain the calcium-phosphate product below 55 mg2/dL2; and to avoid renal calcification (nephrocalcinosis/nephrolithiasis) and other soft tissue calcifications.

• #16 Management of hypoparathyroidism: a Position Statement of the Expert Group of the Polish Society of Endocrinology | Misiorowski | Endokrynologia Polska

  https://journals.viamedica.pl/endokrynologia_polska/article/view/96950?locale=en_US

  The frequency of monitoring of serum calcium, phosphate, and other parameters such as magnesium is very much a function of the extent to which a patient is stable on a given treatment regimen. […] In patients who are not on dialysis, the most important therapeutic issue is a very high phosphate retention, which translates into high calcium-phosphate product levels. […] Therefore, these patients require a restrictive low-phosphate diet and usually the use of noncalcium and calcium phosphate binders. […] In summary, HypoPT treatment in patients with advanced CKD is challenging and requires the involvement of an experienced physician.

• #17 Hypoparathyroidism | Altru Health System

  https://www.altru.org/health-library/conditions/hypoparathyroidism

  Magnesium. If your magnesium level is low and you’re experiencing symptoms of hypoparathyroidism, you may need to take a magnesium supplement. […] Parathyroid hormone replacement. The U.S. Food and Drug Administration (FDA) has approved parathyroid hormone (Natpara) for low blood calcium due to hypoparathyroidism. […] Your health care provider will regularly check your blood to monitor levels of calcium and phosphorus. At first, these tests will probably be weekly to monthly. Eventually, you’ll need blood tests just twice a year. Regular testing allows adjustment of your supplemental calcium dose if your blood-calcium levels rise or fall. […] Because hypoparathyroidism is usually a long-lasting disorder, testing and treatment generally is lifelong.

• #18 Management of hypoparathyroidism: a Position Statement of the Expert Group of the Polish Society of Endocrinology | Misiorowski | Endokrynologia Polska

  https://journals.viamedica.pl/endokrynologia_polska/article/view/96950?locale=en_US

  In pregnant women with HypoPT, it is crucial to maintain corrected serum calcium concentrations in the lower or middle range of their reference values. […] Therefore, serum albumin-corrected calcium should be closely monitored every 3 to 4 weeks during pregnancy and lactation, and more frequently in the months preceding and following childbirth, and also if symptoms of hypercalcemia or hypocalcemia occur, because the demand for calcium and calcitriol may increase, remain stable, or decrease during pregnancy. […] The demand for calcium and calcitriol in lactating women with HypoPT is generally significantly reduced; therefore, it is necessary to monitor serum corrected calcium concentrations and adjust calcitriol doses in line with the reduced requirement. […] In children, HypoPT most often has a genetic etiology and manifests itself either as an isolated condition or as part of multisystem or polyglandular syndromes.

• #19 Hypoparathyroidism – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoparathyroidism/symptoms-causes/syc-20355375

  Accurate diagnosis and treatment might prevent these complications or keep them from getting worse. But once they occur, taking calcium and vitamin D usually doesn’t reverse the damage. Irreversible complications include: […] If you’ve had surgery or radiation involving your thyroid or neck, watch for signs and symptoms that could indicate hypoparathyroidism, such as a tingling or burning sensation in your fingers, toes or lips, or muscle twitching or cramping. If they occur, your health care provider might recommend prompt treatment with calcium and vitamin D to minimize the effects of the disorder.

• #20 Management of hypoparathyroidism: a Position Statement of the Expert Group of the Polish Society of Endocrinology | Misiorowski | Endokrynologia Polska

  https://journals.viamedica.pl/endokrynologia_polska/article/view/96950?locale=en_US

  Over the past few years, there have been significant advances in our understanding of hypoparathyroidism (HypoPT) in terms of its epidemiology, clinical presentation, etiology, and skeletal and renal complications. […] This position statement of the Expert Group of the Polish Society of Endocrinology summarizes the current state of knowledge and provides recommendations for optimal management to assist clinicians in the diagnosis, treatment, and monitoring of HypoPT in Poland. […] The specific aspects of HypoPT management in children, pregnant and lactating women, and patients with chronic kidney disease are also discussed. […] HypoPT is a rare disorder characterized by hypocalcemia and the lack or deficiency of parathyroid hormone (PTH). […] Hypoparathyroidism can be associated with complications, including nephrocalcinosis, nephrolithiasis, renal insufficiency, cataract, seizures, cardiac arrhythmia, depression, and an increased risk of infection.

• #21 Standards of care for hypoparathyroidism in adults: a Canadian and International Consensus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6365672/

  Conventional therapy of hypoparathyroidism consists of the use of calcium supplements, and active vitamin D. […] Management of hypoparathyroidism during pregnancy is challenging with very limited data currently available to guide clinical practice. […] These recommendations reflect current evidence and consensus regarding the appropriate standard of care today. […] In patients with history of thyroid, parathyroid, laryngeal or other neck surgeries, the temporal proximity of the surgical procedure to the development of hypocalcemia, as well as the duration of hypocalcemia, will determine whether this is acute and/or transient hypoparathyroidism or chronic and permanent hypoparathyroidism. […] A low serum albumin-adjusted calcium 2.0mmol/L or 8mg/dL in the presence of a low PTH 15pg/mL is associated with a high risk of permanent hypoparathyroidism and requires appropriate supplementation with calcium and active vitamin D metabolites and follow-up.

• #22 Hypoparathyroidism in Children | Valley Children’s Healthcare

  https://www.valleychildrens.org/endocrinology/conditions/hypoparathyroidism-in-children

  Hypoparathyroidism is when the parathyroid glands dont make enough parathyroid hormone. The hormone they make helps manage levels of calcium in the bloodstream. Low levels of the hormone lead to low levels of calcium. This can lead to muscle spasms and cramping, called tetany. […] A child is at risk for hypoparathyroidism if they have any of these: Previous surgery on the neck or thyroid gland, An autoimmune disease, Family history of hypoparathyroidism, Preterm birth. […] Symptoms can occur a bit differently in each child. They can include: Numbness around the mouth or in hands or feet, Uncontrollable, painful spasms of the face, hands, arms, and feet, Seizures, Low blood pressure, Unstable emotions, anxiety, or depression, Dental problems, Coarse, brittle hair. […] Your child’s healthcare provider will consider the child’s age, overall health, and other factors when advising treatment. Your child may need to see a pediatric endocrinologist. This is a doctor with extra training in treating children with hormone problems.

• #23 Hypoparathyroidism in Children | Valley Children’s Healthcare

  https://www.valleychildrens.org/endocrinology/conditions/hypoparathyroidism-in-children

  Treatment may include calcium given through an IV or through the mouth. This can give relief of symptoms right away. Your child may also need to take vitamin D supplements for life. […] If untreated, the condition can cause serious complications, such as: Uncontrollable, painful muscle spasms, Seizures, Kidney damage, Heart failure, Stunted growth, Dental defects, Cataracts. […] Hypoparathyroidism after neck surgery may go away on its own. But it is usually a lifelong condition. Work with your child’s healthcare providers to create an ongoing plan to manage your childs condition. […] Call your child’s healthcare provider if your child has any symptoms of hypoparathyroidism. […] Hypoparathyroidism is when the parathyroid glands dont make enough parathyroid hormone. The hormone manages levels of calcium in the bloodstream. Low levels of the hormone lead to low levels of calcium. […] Treatment may include IV calcium. This can give relief of symptoms right away. Your child may also need to take calcium and vitamin D supplements for life. […] Hypoparathyroidism after neck surgery may go away on its own. But it is usually a lifelong condition.

• #24 Hypoparathyroidism | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/23275

  The medical management of hypoparathyroidism is done by an interprofessional team that consists of an emergency department physician, endocrinologist, surgeon, and primary care provider. […] All patients with hypoparathyroidism need periodic monitoring of their calcium, phosphorus, renal function, and urine calcium excretion. […] Selected patients who are more challenging to control on traditional therapy could benefit from daily subcutaneous injections of an analog of parathyroid hormone.

• #25 Hypoparathyroidism — Knowledge Hub

  https://www.genomicseducation.hee.nhs.uk/genotes/knowledge-hub/hypoparathyroidism/

  Management of patients with hypoparathyroidism is complex and should be undertaken by a multidisciplinary team. At the very least, it is essential that hypoparathyroidism patients receive care from an accredited adult and/or paediatric endocrinologist. […] Conventionally, treatment of hypoparathyroidism has involved oral calcium supplements and activated vitamin D metabolites (calcitriol or alfacalcidol). However, these treatments are imperfect, often associated with poor quality-of-life scores, ongoing symptomatology, elevated risk of unscheduled hospital attendance or admission and increased risk of development of nephrocalcinosis, nephrolithiasis and impaired renal function. In some regions globally, therapy with recombinant human full-length PTH (rhPTH1-84) is now licensed, although in practice, availability is limited due to licensing, reimbursement and supply difficulties. […] Ongoing gene-directed therapies and trials are investigating the use of rhPTH1-84, rhPTH1-34 and other novel PTH analogues, as well as possible gene therapy for PTH replacement.

• #26 The veterinary nurse’s guide to parathyroid disorders — Veterinary Internal Medicine Nursing

  https://www.veterinaryinternalmedicinenursing.com/blog/parathyroid-disorders

  Though not as commonly encountered as other endocrine diseases, its really important for us as veterinary nurses to be able to spot the signs of parathyroid disorders and know how to nurse and treat these patients. […] This is particularly important in patients with hypoparathyroidism – as these patients can present with potentially life-threatening hypocalcaemia. […] The clinical signs of hypoparathyroidism are associated with hypocalcaemia, and are primarily neuromuscular, since calcium plays a key role in the transmission of nerve impulses to muscles. […] Treatment initially involves correction of hypocalcaemia, usually by intravenous administration initially if calcium levels are severely low, followed by the administration of calcitriol (vitamin D3) and calcium carbonate. […] Nursing care of the hypoparathyroid patient in the hospital involves careful monitoring of their heart rate and rhythm and the prompt identification of arrhythmias if they are receiving IV calcium.

• #27 The veterinary nurse’s guide to parathyroid disorders — Veterinary Internal Medicine Nursing

  https://www.veterinaryinternalmedicinenursing.com/blog/parathyroid-disorders

  Monitoring for signs of hypocalcaemia is also vital, and a hypocalcaemia plan and an emergency pack containing doses, drugs, needles, syringes and monitoring equipment should be on-hand near to the patient. […] These patients often require regular follow-up visits for blood sampling to recheck their calcium levels, and the veterinary nurse can perform these in a nurse clinic, alongside collecting an updated clinical history and examining the patient.

• #28 Standards of care for hypoparathyroidism in adults: a Canadian and International Consensus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6365672/

  rhPTH(184) replacement therapy may be considered if the serum calcium is poorly controlled, high doses of calcium or active vitamin D are required, renal complications are present or quality of life is poor or gastrointestinal malabsorption is present. […] Hypoparathyroidism is a rare condition, which requires careful evaluation and timely pharmacologic intervention in order to prevent significant morbidity and mortality. Frequent laboratory monitoring of the biochemical profile and patient education is essential to achieving optimal control of serum calcium and potentially lowering the risk of long-term complications.

• #29 Addressing Unmet Needs: Novel Therapies in the Treatment of Adult Hypoparathyroidism – Endocrinology Advisor

  https://www.endocrinologyadvisor.com/cch/hypoparathyroidism-parathyroid-hormone-palopegteriparatide-calcium-vitamin-d/

  PTH therapy has been shown to improve QOL, reduce pill burden, and lower serum phosphate levels while maintaining serum calcium in the normal reference range. […] Long-term follow-up studies have not demonstrated an increase in the risk of osteosarcoma, and it is a valuable and safe treatment option for patients with hypoPT. […] Patients with hypoPT do have significantly impaired QOL due to multiple factors. The wide fluctuations in serum calcium are disabling in many patients and the neurologic manifestations with numbness and tingling in the face, hands, and feet can prevent an individual from engaging in a meaningful work schedule. […] Conventional therapy can certainly improve serum calcium but may not be able to eliminate the fluctuations in serum calcium and may not be able to improve QOL. […] We have noticed dramatic improvements in well-being, function, and QOL with the implementation of PTH therapy.

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