Endocrine Abstracts

Introduction: Primary Hypoparathyroidism is a rare endocrine disorder characterized by hypocalcaemia associated with an inappropriately low parathyroid hormone concentration. As currently there are no UK guidelines for the management of this condition, we performed an audit comparing our performance with published European guidelines (1). These state that

• Patients should be educated both to facilitate identification of hypocalcaemia and hypercalcaemia and to increase awareness of potential complications.

Methods: The notes of 18 patients aged 25–85 years with primary hypoparathyroidism for at least 1 year, managed in a single hospital by several consultants, were reviewed. Data was obtained from the clinical notes, the computerised endocrine database and the local pathology system.

Results: The most common aetiology was previous thyroidectomy. The target for calcium was stated in only 38.9% and for phosphate in only 11.1%. Serum Calcium and phosphate were measured annually in 83%. Serum Vitamin D was measured in 20% and magnesium in 28%. Annual 24 h urine calcium excretion was checked in 12.5%. In no patient was the calcium phosphate product recorded. Quality of life was informally assessed in 33%. No one had a formal assessment recorded. There was no recorded evidence of formal education.

Conclusion: It is evident that locally, the long term outpatient monitoring and recording of Primary hypoparathyroidism is inadequate. We have therefore constructed a ten point checklist of relevant variables to standardise management and facilitate further audit.