Endocrine Abstracts

Hypoparathyroidism is a rare endocrine disorder whose epidemiologic characteristics regarding the cause, clinical course, acute and chronic complications have not been well defined. There is also a substantial geographic variability regarding those parameters, and country-specific local data is scarce.

This study was conducted to assess the baseline characteristics, including the demographics, etiologic distribution, disease severity, medications used, frequency of acute and chronic complications, and treatment/follow-up patterns of patients with chronic (>6 months) hypoparathyroidism in Turkey. The 30 centers that participated in the study filled out the data of their registered adult hypoparathyroid patients, retrospectively, through detailed questionnaires using their patient records. Overall, 738 hypoparathyroid patients were included in the analysis. The mean age of the patients was 48.5 ± 13.3 years, and the majority were female (83.9%). The most common etiology of hypoparathyroidism was surgical damage to the parathyroid gland (postsurgical group; n = 661, 89.6%) following a complete/partial thyroidectomy, parathyroidectomy and/or neck dissection with an indication of Graves disease in 31 (5.5%), multinodular goiter in 282 (49.6%), thyroid cancer in 155 (27.3%) and toxic nodular/multinodular goiter in 100 (17.6%). The nonsurgical cohort included 77 (10.4%) patients. The patients had a mean disease duration of 9.5 ± 6.9 years. The majority (n = 593, 81.6%) were diagnosed shortly after the operation that caused hypoparathyroidism while 19 (2.6%) patients had a diagnosis since childhood, another 89 (12.2%) were diagnosed as outpatients with mild symptoms of hypocalcemia, 18 (2.5%) withemergency department admission due to hypocalcemic tetany, and 8 (1.1%) were asymptomaticduring the routine blood tests that led to the diagnosis. Of all patients in our cohort, 117 (15.9%) had serum calcium measurements <7.5 mg/dl, 111 (15.1%) between 7.5–8.0 mg/dl, 200 (27.1%) between 8.0–8.5 mg/dl, 304 (41.3%) between 8.5–10.5 mg/dl and 5 (0.7%) >10.5 mg/dl under their current treatment. The postsurgical and the nonsurgical groups did not differ in terms of age, BMI, and duration of disease. The nonsurgical group had a lower nadir plasma PTH concentration than the postsurgical group (2.28 ± 2.77 vs 10.08 ± 7.92, P < 0.0001) while their current daily dose of calcitriol and corresponding serum calcium levels on treatment were similar. In conclusion, the etiology of hypoparathyroidism is predominantly surgery-induced in our cohort. Most patients are under 1–2 times yearly follow-ups, and their serum calcium levels are in an acceptable target range. Rates of screening for chronic complications are below desired levels and need to be improved.