Endocrine Abstracts

Background

Hypoparathyroidism is a rare disorder characterized by hypocalcemia and hyperphosphatemia due to absent or inadequate parathyroid hormone secretion. Data on effective treatment strategies and predictors of long-term complications have only recently began to emerge. The epidemiological information regarding chronic hypoparathyroidism in Russia is strictly limited that prompted this research.

Aims

To estimate the clinical course, demographic features and treatment regimes in patients with chronic postsurgical and nonsurgical hypoparathyroidism.

Materials and methods

The database of patients with chronic postsurgical and nonsurgical hypoparathyroidism from Endocrinology Research Centre was used for retrospective analysis. The study included 357 patients from 61 regions of the Russian Federation. The descriptive statistics are presented by medians (Me) and the first and third quartiles (Q1; Q3) and by absolute and relative frequencies.

Results

Hypoparathyroidism was most frequent in women (85.4%) at the age of 43 [32; 52] years. The prevalence of chronic postsurgical hypoparathyroidism was 86%, most often it occurs after thyroid surgery, especially because of thyroid carcinoma and multinodular goiter. In a subanalysis of patients who underwent thyroid surgery hemi- and thyroidectomy were noted in 7% and 93% respectively. Nonsurgical hypoparathyroidism was registered in 14% of patients (n = 50: idiopathic (28), autoimmune (13) and other genetic form of disease (9) with. Less than a half of the study group had target indicators of serum calcium and phosphate levels (32% and 47%, respectively) despite ongoing treatment. Among the disease complications, kidney disorders were detected in 38%, visual disturbance in 14%, brain calcification in 6%, arrhythmias in 7% and neuropsychiatric symptoms in 8%. Conventional therapy with calcium supplements and activated vitamin D analogues was noted in 71% of patients. The mean dose of calcium supplements was 1837 mg/day (per elemental calcium) and 1.74 mg/day for alfacalcidol.

Conclusions

This study represents one of the first large-scale epidemiological assessments of chronic postsurgical and nonsurgical hypoparathyroidism in Russian Federation. Longitudinal prospective studies are necessary to permit a better understanding of the clinical manifestations, short- and long-term complications, and therapeutic approaches of disease. Being aware of our current management of this rare disease is the first step to improving our clinical approach in the future.