Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Geiger, S.
Hypoparathyroidism: a retrospective observational study – update 2021
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2022. pp. 111
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Amrein Karin
- Tmava-Berisha Adelina
- Altmetrics:
- Abstract:
- Introduction: Hypoparathyroidism (HPT) is a rare endocrine disorder characterized by hypocalcaemia and inadequately low parathyroid hormone levels. Symptoms can be typical, such as paraesthesia, tetany, and spasms, but can also be unspecific, including fatigue, brain fog and concentration disorders. In 75% HPT is caused by anterior neck surgery, other aetiologies include autoimmune, genetic, and idiopathic causes. Conventional therapy consists of oral calcium and active vitamin D supplementation and since 2017 hormone replacement therapy with recombinant human parathormone (rhPTH (1-84)) is available if therapy goals cannot be met conventionally. Long-term complications of chronic HPT include renal, neuropsychiatric and cardiovascular complications. Methods: We identified 191 patients with chronic HPT in Styria and analysed their medical and laboratory data from 2004-2022 using MEDOCS. Results: 70% of all patients were female and 30% male. The mean age was 62 years and 82% had postsurgical HPT with a median time of 2.5 years from surgery to diagnosis. Most surgeries were performed because of thyroid cancer (30%) or goitre (22%). 90% had secondary diseases, the most prevalent being cardiovascular disease (34%), followed by renal (27%) and neurologic disease (14%). Patients receiving rhPTH (1-84) were younger (p<0.001), had lower serum calcium levels (p<0.001), lower daily oral calcium doses (p=0.027) and lower 1,25-hydroxyvitamin D levels (p<0.001). 27% of all patients mentioned symptoms at their last visit. The number of hospital visits correlated with the number of secondary diseases (p=0.011). 42% of all patients had a median eGFR below 60 ml/min/1.72 in their last year. The median eGFR lost across all patients per year was 1.5 ml/min/1.72. Anaemia was present in 30% of patients at their last visit. From 2011-2021 about 44% of patients were anaemic each year. Anaemia was more prevalent in patients with CKD grade 3 or worse (OR 3.3; p<0.001) and in patients with more comorbidities (p=0.024). 90% of anaemias were normocytic/normochromic. Conclusion: Chronic hypoparathyroidism is a complex disease and long-term complications are highly relevant for many patients. These complications are linked to a lower quality of life. Anaemia is also highly prevalent. Management and prevention of these complications will most likely be an important field of future research, as they may cause a high burden of disease and costs and many of the mechanisms involved are still unknown.