Endocrine Abstracts

Background: Hypoparathyroidism (HypoPT) is a rare condition that is characterized by hypocalcemia and hyperphosphatemia due to low or inappropriately normal serum levels of parathyroid hormone (PTH) for at least 6 months. The long-term complications of hypoparathyroidism indicate the necessity of screening them. In the follow-up of these patients according to hypoparathyroidism guidelines is recommended; calcium, phosphorus, albumin, magnesium, creatinine, and eGFR levels should be checked annually or more frequently than clinical status. A 24-hour urine calcium excretion is recommended once a year. Renal imaging is recommended in patients with elevated creatinine or high urinary calcium excretion, or patients suggesting renal stones. For basal ganglia calcification, brain MRI or CT is advised. A yearly eye examination is recommended for cataracts. In our study, in the long-term follow-up of hypoparathyroidism patients, it was examined whether the guidelines were followed.

Methods: Between February 2019 and September 2021, patients aged ≥18 years with hypoparathyroidism who were followed by the routine scheduled monitoring visit at the outpatient clinic of the endocrine and had their data retrospectively documented. Comorbidities, imaging, and hormonal tests and results of these patients were evaluated.

Results: Among the 264 patients, the mean age was 49.34± 12.98 (22-91). 211 (79.9%) of the participants were female. All patients’ had blood biochemistry tests. Of the patients, 3% had eye examinations, 9.8% had brain imaging, 18.6% had renal imaging, 11 % had 24 h urinary Ca results. Cataract was observed in 2 (0.8%), basal ganglia calcification was observed in 4 patients (1.5%). Nephrocalcinosis or nephrolithiasis was observed in 2 patients (0.8%). Hypercalciuria was defined as a 24 h urine calcium excretion >300 mg/24 h and was observed in 8 of participants with hypoparathyroidism. (Table 1)

Conclusion: In the follow-up of patients with hypoparathyroidism, the guidelines cannot be followed much in intensive outpatient clinic conditions. These patients screening for complications is as important as blood tests.