Summary
Definition
History and exam
Ключевые диагностические факторы
- história de cirurgia de tireoide, paratireoide ou laringe
- alcoolismo crônico
- desnutrição, má absorção, diarreia
- contrações musculares, espasmos, cãibras
- parestesias, dormência
- memória fraca, raciocínio lento
- sinal de Chvostek
- convulsões
- batimento cardíaco irregular, taquicardia
- sinal de Trousseau
Другие диагностические факторы
- ansiedade
- cabelo seco, unhas quebradiças
- catarata
- história de candidíase mucocutânea
- história de transfusões crônicas em pacientes com talassemia
- dispneia
- laringoespasmo
Факторы риска
- cirurgia de tireoide
- cirurgia de paratireoide
- hipomagnesemia
- hipercalcemia materna moderada e crônica (hipocalcemia neonatal)
- doenças autossômicas dominantes (por exemplo, mutações em CASR, GATA3)
- hemocromatose hereditária
- sobrecarga férrica transfusional na talassemia
- Doença de Wilson
- câncer metastático
Диагностические исследования
Исследования, которые показаны в первую очередь
- cálcio sérico
- nível plasmático de paratormônio (PTH) intacto
- albumina sérica
- magnésio sérico
- 25-hidroxivitamina D sérica
- fósforo sérico
- creatinina sérica
- eletrocardiograma (ECG)
Исследования, проведение которых нужно рассмотреть
- cálcio e creatinina urinários de 24 horas
- magnésio e creatinina de 24 horas
- testes da função hepática
- gasometria arterial
- tiroxina livre sérica, tireotrofina
- teste de estímulo com hormônio adrenocorticotrópico (ACTH) e níveis de cortisol pela manhã
- hemograma completo
- ferro, transferrina e ferritina séricos
- cobre sérico
- exame oftalmológico
- audiologia
- cintilografia renal
- autoanticorpos para interferon tipo 1 ou 21-hidroxilase
- sequenciamento do gene
Алгоритм лечения
hipocalcemia sintomática grave (cálcio total sérico corrigido para albumina <1.88 mmol/L [<7.5 mg/dL])
hipocalcemia temporária pós-cirúrgica assintomática
hipoparatireoidismo crônico
Составители
Авторы
Dolores Shoback, MD
Professor of Medicine
University of California San Francisco
Endocrine Research Unit
San Francisco VA Medical Center
San Francisco
CA
Раскрытие информации
DS declares that her institution receives research money from Ascendis Pharmaceuticals to conduct a clinical trial in hypoparathyroid patients on which she is the Principal Investigator. This company is testing a new treatment for hypoparathyroidism. DS has participated in an advisory board for Ascendis (Dec 2022) to review data on this new treatment.
Quan-Yang Duh, MD, FACS
Professor of Surgery
Section of Endocrine Surgery
University of California San Francisco
San Francisco
CA
Раскрытие информации
QYD declares that he has no competing interests.
Выражение благодарностей
Professors Dolores Shoback and Quan-Yang Duh would like to gratefully acknowledge Professor Ronald Merrell, a previous contributor to this topic.
Раскрытие информации
RM declares that he has no competing interests.
Рецензенты
Wail Malaty, MD
Adjunct Clinical Professor
Department of Family Medicine
University of North Carolina
Chapel Hill
NC
Раскрытие информации
WM declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Khan AA, Bilezikian JP, Brandi ML, et al. Evaluation and management of hypoparathyroidism summary statement and guidelines from the Second International Workshop. J Bone Miner Res. 2022 Dec;37(12):2568-85.Полный текст Аннотация
Mannstadt M, Cianferotti L, Gafni RI, et al. Hypoparathyroidism: genetics and diagnosis. J Bone Miner Res. 2022 Dec;37(12):2615-29.Полный текст Аннотация
Orloff LA, Wiseman SM, Bernet VJ, et al. American Thyroid Association statement on postoperative hypoparathyroidism: diagnosis, prevention, and management in adults. Thyroid. 2018 Jul;28(7):830-41.Полный текст Аннотация
Gafni RI, Collins MT. Hypoparathyroidism. N Engl J Med. 2019 May 2;380(18):1738-47. Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Hipomagnesemia
- Hipoalbuminemia
- Doença renal crônica
Больше ОтличияРекомендации
- Evaluation and management of hypoparathyroidism: summary statement and guidelines
- Standards of care for hypoparathyroidism in adults: a Canadian and international consensus
Больше РекомендацииVideos
Sinal de Trousseau
sinal de Chvostek
Больше Видео
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