Hypoparathyroidism

February 5, 2013

Related Articles:

• Minerals in traditional medicine
• Calcium chloride
• Potassium protects women against stroke
• No-spa in pregnancy

Tweet

Hypoparathyroidism   - It is a disease that develops in the human body as a consequence of shortage PTH   or in violation of the receptor tissue sensitivity to it. This substance is produced parathyroid glands . The activity of the parathyroid glands is reduced due to various reasons, people of any age (according to the statistics, the disease occurs in 0, 3-0, 4% of the population ). Therefore, the disease is rare. The consequence of this disease is in violation of metabolic processes Calcium   and Phosphorus Which leads to hypocalcemia   (bone and decreases blood calcium) and hyperphosphatemia   (increasing the level of Phosphorus ).

Causes of hypoparathyroidism

Exchange Calcium   and Phosphorus   in humans provide PTH . calcitonin   (thyroid hormone), and Vitamin D . Therefore, when a lack of parathyroid hormone, not only violated the exchange, but fails in the mineral balance (there is no balance between by K . Na . Mg ). Decreases the permeability of cell membranes, whereby there has been increasing neuromuscular excitability, and having convulsions . Furthermore, the patient hypoparathyroidism calcium salts are deposited on the walls of blood vessels and internal organs.

Primary hypoparathyroidism manifests itself due to lack of, or damage to the complete removal of the parathyroid glands.

The disease also often develops in people with thyroid cancer, as there is a functional relationship between this gland and parathyroid glands.

The reasons that contribute to the development of this disease is a number of factors.

Hypoparathyroidism in children and adults are sometimes seen after the surgery on the thyroid gland, or after surgery on other organs of the neck, which can be damaged in the parathyroid glands. Postoperative hypoparathyroidism, usually develops in patients who because of the cancer is completely removed the thyroid gland.

There are other causes of the disease: bleeding in the parathyroid glands, which occur after a neck injury, inflammation in these glands Metastasis   in the neck directly into the parathyroid glands in cancer.

The symptoms of hypoparathyroidism may also appear as a consequence of congenital diseases of the parathyroid glands, the action of radiation on the human body, with endocrine disorders, and systemic autoimmune diseases.

Treatment for hypoparathyroidism should be carried out immediately after the establishment of the diagnosis. Indeed, in severe cases, the disease may be a consequence of even disability patient.

Classification

Modern hypoparathyroidism experts are divided into several different forms, guided by the characteristics of the disease. With acute form   disease in a patient relatively frequent bouts of severe seizures occur, it is compensated by the state hard.

With chronic form hypoparathyroidism attacks occur infrequently. This comes after getting an infection in the body, and as a result of strenuous exercise, stress. Women aggravation may occur after menstruation. Most often, the disease is exacerbated in the spring and autumn periods. With the right approach to treatment there are long periods of remission.

With latent form hypoparathyroidism there is no external manifestations of the disease, and symptoms of the disease can only be determined when the special examination of man.

There is also a classification, which takes into account the reasons for which manifested hypoparathyroidism:

• Postoperative   - Develops as a consequence of surgery in the neck or on the thyroid gland.
• Posttraumatic   - Manifested after irradiation or exposure on the body of infection, and as a result of injury, hemorrhage, etc..
• Congenital   - When the unborn fetus.
• Idiopathic . Autoimmune hypoparathyroidism .

Symptoms

The main symptom is the development of hypoparathyroidism seizure (tetanic) syndrome . Seizures occur as a consequence of severe neuromuscular excitability, which manifests itself with a decrease in production of parathyroid hormone in the body. As a consequence, a person suffering from intense muscle contractions, which are accompanied by pain.

Before the start of an attack of convulsions person may feel numbness, stiffness of muscles. Sometimes there is a feeling of " chills "On the fingers of limbs, above the upper lip. Legs and arms may grow cold. All this - the harbingers of seizures. Typically, twitching occur in separate groups of muscles which are arranged symmetrically on both sides. Initially covering the arm muscles spasm, and then - the leg muscles. Seizures can also affect the muscles of the face, and the muscles of the internal organs of the body are exposed to seizures is very rare.

When seizures upper and lower extremities are usually affected flexor. If the cramp strikes arm limb is bent at the elbow and carpal joints and pressed to the body. When convulsions in a patient faces compressed jaw shifted brows lowered corners of the mouth and eyelids.

In convulsions vessels of the heart attack felt a sharp pain in the heart. Seizures occur straightening the torso of the body back. Patients whose seizures originate neck, intercostal muscles of the diaphragm or abdominal muscles difficulty breathing, appears bronchospasm and breathlessness . If seizures include stomach, esophagus, intestines, then violated swallowing function, can develop constipation . intestinal colic . When developing bladder spasms anuria   (patient no urination).

Convulsions in hypoparathyroidism are always painful. If the patient has a mild form of the disease location, similar attacks may occur up to 2 times a week, while the attack lasts several minutes. In severe hypoparathyroidism cramps can develop a few times a day, while the attack lasts for several hours. Sometimes seizures develop spontaneously, but often their origin is due to the impact of a specific external stimulus. When muscle spasms in a patient may turn pale skin, there are pressure drops, heart palpitations, digestive problems. Sometimes, in severe illness, people may even lose consciousness.

It appears in this disease, and autonomic disorders : Strong sweating, fainting, dizziness Sensations of tinnitus and hearing loss, impaired concentration level, and the view at dusk. It may also violate the sensitivity of receptors, resulting in marked increase in the perception to loud noises, to the bitter and sweet food, the sharp sensation of heat or cold.

If low levels of calcium observed over a long period, patients may also suffer from significant changes in the psyche. They have reduced memory, intellect, of manifestations depression , bad dream.

In the chronic form of the disease occur trophic disorders. There are changes in the condition of the skin: it becomes dry and scaly. It may change the pigmentation develop fungal diseases, eczema. Disturbed hair growth, sometimes marked baldness, graying in young age. It can damage tooth tissues, most notably seen in children during tooth formation. For adult patients characterized by the development caries . Children can also keep up with the growth of healthy peers.

Patients who suffer hypoparathyroidism long period can occur cataract . If the patient holds the latent form of disease, the seizures may occur in infectious diseases, pregnancy, toxicity, lack of vitamins.

Complications

If a person's blood level of calcium is sharply reduced, the consequence of this phenomenon could be the development of hypocalcemic crisis. Development of convulsive seizure occurs spontaneously or under the influence of stimuli. In convulsions limbs, tenderness, and bronchospasm   and laryngism   It can be dangerous for the life of the patient, as there was a sharp respiratory disorders. Especially dangerous are such things to children.

Some phenomena in hypoparathyroidism are irreversible. In this case it is the calcification of brain tissue, and other organs, as well as cataracts.

Diagnostics

During the initial diagnosis specialist carries out an external examination of the patient, as well as exploring the history. The physician should find out whether surgery on the thyroid or parathyroid glands, whether the patient was exposed to radiation therapy. Furthermore, it is important to determine whether its increased neuromuscular excitability.

Further laboratory tests are conducted, in which content is determined in blood and urine of parathyroid hormone, calcium, phosphorus. Work is also X-ray examination, which allows to define rib cartilage calcification . osteosclerosis . Densitometric examination reveals an increased bone density. Sometimes the patient also conduct an MRI to determine the presence of calcium deposits in the internal organs, the brain tissue in the subcutaneous tissue. To determine the arrhythmia, which causes gipokaltsimiya assigned holding ECG.

To determine the hidden forms of hypoparathyroidism patient is assigned to conduct tests that allow to define an increased seizure.

Treatment

It is important that the treatment of hypoparathyroidism was conducted under the constant supervision of a specialist endocrinologist. The therapy chosen to prevent seizures. The patient should always observe the special diet Rich foods and meals with a high content of calcium and at the same time with a low phosphorus content. This dairy products, fruits and vegetables. If there is a worsening of the disease, the patient should be completely abandon meat products. In addition, the diet should contain products fortified vitamin D2 - egg yolk . fish fat . liver .

Treatment for hypoparathyroidism provides calcium supplementation. To increase the absorption in the gut of the element parallel to the patient prescribers ammonium chloride, dilute hydrochloric acid or gastric juice .

In addition, drugs used vitamin D. To make the process of developing vitamin D in the body is more intense, the patient should stay moderate in the sun or ultraviolet radiation physiotherapy.

To prevent symptoms of cramps, appointed sedatives and anticonvulsants, and antispasmodic drugs. In order to reduce the intake of phosphorus in the intestine of patients showing reception aluminum hydroxide, which is able to bind phosphorus in the bowel. With the development of hypocalcemic crisis intravenously a solution of calcium gluconate.

One of the new treatments for hypoparathyroidism is a surgical procedure - transplantation of parathyroid glands .

Treatment of chronic forms of the disease continues throughout life. The doses of drugs must choose a doctor and the right approach to the treatment of the patient's condition fails to normalize.

Prevention

To prevent the development of hypoparathyroidism should apply sparing surgical technique during surgery on the thyroid gland. It should be very attentive to the issue of prevention of complications after such surgery, to prevent the formation of adhesions, infiltrates. If patients who have had this operation, showing signs of high neuromuscular excitability, it is necessary to immediately examine the patient and ensure proper treatment.

It is important to exclude the impact of trigger factors gipoparatireoze to prevent seizures and symptoms of acute hypocalcemic crisis. An important measure of both in treatment and in prevention is proper nutrition.