Hypocalcaemia - Wikipedia
Hypocalcemia is defined as an ionized calcium concentration below the lower limit Hypoparathyroidism is most commonly the result of parathyroid or thyroid . Neuromuscular signs or symptoms due to hypocalcemia are the main .. calcium supplements and activated vitamin D metabolites is not well defined. of this impairment and its relationship to biochemical control or other. A diagnosis can be made based on the presence of hypocalcemia, . which explains both the steep inverse relationship between PTH levels and small changes.
Textbook of Veterinary Internal Medicine, ed 3. Chew D, Nagode L: Treatment of hypoparathyroidism, in Bonagura JD ed: Saunders Manual of Small Animal Practice, ed 2. Familial isolated hypoparathyroidism caused by a mutation in the gene for the transcription factor GCMB.
J Clin Invest 8: Update on the diagnosis and treatment of disorders of calcium regulation. Hyperparathyroid and hypoparathyroid disorders. N Engl J Med A versatile regulator of diverse cellular functions. Vitam Horm Primary hypoparathyroidism in a cat complicated by suspect iatrogenic calcinosis cutis.
News & Articles
Hypoparathyroidism, in Kirk RW ed: Current Veterinary Therapy IX. Small Animal Internal Medicine, ed 3. Louis, Mosby,pp Is idiopathic hypoparathyroidism an autoimmune disease?
- Hypoparathyroidism: Pathophysiology and Diagnosis
J Clin Invest 97 4: Primary hypoparathyroidism in a cat. Idiopathic hypoparathyroidism in five cats. J Vet Intern Med 5 1: Primary hypoparathyroidism in the dog. J Vet Intern Med Urena P, Frazao J: Calcium-sensing receptor and calcimimetic agents. Kidney Int Suppl Secondary hypoparathyroidism attributed to hypomagnesemia in a dog with protein-losing enteropathy.
Cole and Geoffrey N. Denko and Kaelbling estimate that at least half the cases attributable to surgery have psychiatric symptoms, and that the frequency is probably higher still in idiopathic hypoparathyroidism Such patients [both types] may show sustained difficulty with concentration, emotional lability [mood swings and easily upset] Children show temper tantrums and night terrors, and adults become depressed, nervous and irritable with frequent crying spells and marked social withdrawal More rarely, psychotic illness of manic-depressive or schizophrenic type may be seen, particularly in cases due to surgery Paresthesias in the fingers, toes and perioral region are a common finding.
Muscle cramps may occur in the lower back or legs. These include mental changes, emotional lability, irritability, depression, memory impairment, subnormal intelligence, retardation, and functional psychoses. Since all are attributed to hypocalcemia, treatment may improve intelligence and personality but symptom improvement is not guaranteed in all patients.
However, there exist many cases of hypoparathyroidism demonstrating oligophenia without intracerebral calcifications. Tetany, muscle cramps and seizures respond quickly following calcium replacement.
Movement disorders, which usually appear late during the course, also respond towards calcium therapy, while dementia is the least likely to respond.
Parkinsonism and choreoathetosis, rare movement disorders during hypoparathyroidism are extrapiramidal in nature and their relationship with intracranial basal ganglia calcifications is rather obscure.
Hypoparathyroidism - Too Little Parathyroid Hormone Production
These two extrapiramidal syndromes are caused by completely different neuropharmacological mechanisms. Thus, movement disorders are caused by structural rather than by hormonal or electrolyte factors.
These symptoms are caused by circulatory insufficiency due to calcification or abnormal excitation of basal ganglion cells due to hypocalcemia. This article reviews the differential diagnosis of psychiatric and endocrine disorders.
The range of endocrinopathies is presented, with emphasis placed on the common psychiatric symptomatology associated with these conditions. Various signs and symptoms that might stimulate a psychiatrist to pursue a work-up for each endocrine disorder are also emphasized. Keys to identifying the underlying disorder. The presence of cognitive deficits in a patient presenting with anxiety, depression, or another apparently "functional" psychiatric complaint should raise the index of suspicion of organic etiology, with endocrine disorders high on the list.
Psychiatric symptoms secondary to endocrine disturbance generally reverse, albeit slowly, with treatment of the primary hormonal abnormality.
A patient afflicted with this condition simply has too little or a complete absence of parathyroid tissue; therefore, inadequate PTH is produced.
There are 2 major causes of this problem: Hypoparathyroidism Following Thyroid or Parathyroid Surgery The first and by far most common cause of inadequate parathyroid hormone production is the accidental removal of parathyroid glands during thyroid surgery. This is a well known but uncommon complication of thyroid surgery and is one of the primary dangers of thyroid surgery. A number of research studies have shown that surgeons with little experience in thyroid surgery are much more likely to accidentally remove the parathyroid glands2,3.
These studies have shown that surgeons performing more than thyroid operations per year are much less likely to have these complications. This is why most endocrinologists will explain to their patients that they should find the most experienced thyroid surgeon available. Many patients who have a very successful thyroid operation can have a transient inadequate secretion of PTH for several days following surgery on the thyroid, so the diagnosis of post-surgical hypoparathyroidism cannot be made immediately following surgery.
It is common for surgeons to give their thyroid patients calcium pills for a few days after surgery to prevent any symptoms from the transient lack of PTH. Since hyperparathyroidism is typically caused by one or more parathyroid tumors, surgery for hyperparathyroidism is aimed at removing the parathyroid tumor s and leaving behind the normal parathyroid glands.
We all have 4 parathyroid glands, but we can live just fine and not have hypoparathyroidism if we have half of one parathyroid gland that is functioning normally. The goal of parathyroid surgery is to remove those parathyroid glands that are overproducing PTH. But occasionally, too much parathyroid tissue is removed during the operation. Like thyroid surgery, the incidence of this complication is related to the experience of the surgeon and is why endocrinologists typically recommend surgeons with the most experience.
Idiopathic HypoparathyroidsimDeficient parathyroid hormone PTH secretion without a defined cause is termed idiopathic hypoparathyroidism.