Hypoparathyroidism
Hypoparathyroidism is a disease caused by a decrease in the production of parathyroid hormone, which is a consequence of damage or complete removal of the parathyroid glands. The main signs of the disease are the development of convulsive syndrome, hypocalcemia, hyperphosphatomy, violation of phosphorus–calcium metabolism.
Intoxication, infection, or removal of the parathyroid glands during thyroid resection provoke the onset of hypoparathyroidism.
CAUSES OF HYPOPARATHYROIDISM
The main cause of hypoparathyroidism is parathyroid hormone deficiency, accompanied by hyperphosphathy and hypocalcemia. The lack of parathyroid hormone provokes a decrease in the synthesis of the active form of vitamin D, which causes the electrolyte balance of the body. All this causes increased neuromuscular excitability.
TYPES OF HYPOPARATHYROIDISM
There is an obvious and hidden form of hypoparathyroidism.
The latent form does not have sudden bouts of tetany. Patients report feelings of goosebumps and cold in the extremities, twitching in the muscles and nervousness. If a provoking factor is manifested (hyperventilation of the lungs, intoxication, diarrhea, vomiting, lactation, pregnancy, infections), then the latent form turns into an explicit one.
Spontaneous seizures are characteristic of the explicit form. The greatest danger is represented by convulsions of the respiratory muscles, diaphragm and bronchospasms, which are most often found in children.
The chronic form of hypoparathyroidism proceeds more mildly. If adequate treatment is prescribed in time, then long remission periods without seizures are achieved.
In the absence of proper treatment of hypoparathyroidism in an explicit or latent form, it can be complicated by a hypocalcemic crisis occurring with frequent bouts of tetany. In addition, in the absence of treatment, mental and endocrine disorders develop, turning into depression.
SYMPTOMS OF HYPOPARATHYROIDISM
The main symptom of hypoparathyroidism is tonic seizures. Before the attack, the patient feels a feeling of crawling goosebumps, cold limbs, numbness. They provoke cramps, muscle tension or pain. At first, cramps are noted in the legs and arms, and then they pass to the face and torso. When the convulsions affect the muscles of laughter on the face, a grin freezes on the face. Convulsions cause sharp pain and hardening of the muscles. In some cases, there may be isolated spasms of smooth muscles.
If tetany of the sympathetic nervous system prevails during the attack, patients have an increase in blood pressure, tachycardia, and severe pallor. If the autonomic nervous system is affected, swallowing is disrupted during the attack, vomiting, diarrhea, bradycardia, hypertension, dysuria and polyuria are noted, since the tone of the bladder and intestines changes.
DIAGNOSIS OF HYPOPARATHYROIDISM
Hypoparathyroidism is diagnosed on the basis of anamnesis (surgical removal of the parathyroid glands and thyroid gland) and the main signs of increased neuromuscular excitability. To do this, testing is carried out for the Hostek and Trousseau symptom.
Confirmation of this diagnosis is:
· Decrease in blood parathyroid hormone.
· Hypocalcemia.
· Hypophosphaturia.
· Hypocalciuria.
TREATMENT OF HYPOPARATHYROIDISM
The main direction of treatment of the disease is the normalization of phosphorus–calcium metabolism and the prevention of seizures. To do this, medication therapy, vitamin therapy and a diet with a high content of calcium and magnesium (fruits, vegetables, dairy products) are prescribed, while limiting products with phosphorus content (meat).
