This is an automatically translated article.
Hypoparathyroidism is a common disease involving the parathyroid glands when there is an underproduction of parathyroid hormone. Patients with hypoparathyroidism often present with hypocalcemia and hyperphosphatemia. If not treated in time, it will affect the central nervous system, the function of other organ systems.
1. What is the cause of hypoparathyroidism?
Did you know the following factors can cause hypoparathyroidism?
1.1 After surgery Accidental injury or removal of the parathyroid gland during surgery is a common cause of hypoparathyroidism. That surgery can be done as a treatment for thyroid disease or throat cancer.
1.2 Autoimmune disease A phenomenon in which the immune system produces antibodies against the parathyroid tissue itself. When this happens, the parathyroid glands will stop producing the hormone PTH, causing hypoparathyroidism.
In addition, in some cases, such as: Radiation therapy for cancer that expands to the face or neck can destroy the parathyroid gland, as is the case with radioactive iodine treatment for hyperthyroidism. At the same time, changes in magnesium levels will affect the parathyroid glands.
Nồng độ Magie thay đổi cũng làm ảnh hưởng đến tuyến cận giáp
2. Symptoms of hypoparathyroidism
When you experience the following symptoms, you may have hypoparathyroidism.
Muscle aches or cramps Tingling, heat or numbness in the fingertips, toes and lips Muscle spasms, especially around the mouth Hair loss in patches Dry skin Brittle nails Fatigue Feeling anxious Anxiety or sadness Menstrual pain Convulsions, epilepsy In the unfortunate case of children with hypoparathyroidism, headaches, vomiting or dental problems such as weak enamel, poorly developed teeth can also occur.
2.1 Subclinical symptoms Blood tests:
Low blood calcium: 1.87 - 2mmol/l Ionized calcium decreased <1.1 mmol/l Blood phosphorus increased > 1.44 mmol/l PTH decreased < 10pg/ml Urinalysis: Low urinary calcium index < 2.5 mmol/24 h
Electrocardiogram: QT and ST prolongation
Calcium levels may decrease due to other causes.
Chronic kidney failure Syndrome of reduced absorption of calcium, magnesium, vitamin D in the intestine. In patients with a history of taking anticonvulsants (barbituric, phenytoin), rifampicin reduces the synthesis of enzymes that convert vitamin D to Calciferol in the liver. Other causes: Severe acute pancreatitis, thyroid cancer
Ung thư tuyến giáp cũng là nguyên nhân làm nồng độ calci giảm
3. Treatment of hypoparathyroidism
Patients with hypoparathyroidism are indicated for emergency treatment when having laryngospasm, or having a seizure
In case of necessity, the patient is prescribed intravenous injection of 10 - 20ml of 10% Calcium Gluconate (1 - 10 ml). 2 ampoules) by slow intravenous injection over 10 minutes. Or Calcichloride is also used similarly. Patients with hypoparathyroidism are prescribed intravenous calcium infusion at a dose of 1mg/kg/h. Each 10ml ampoule of Calcium Gluconate contains 90mg per 2.25mmol elemental Calcium. Thus, if you mix 6 ampoules of Calcium Gluconate into 500ml of 5% Glucose infusion at a rate of 0.92 ml/kg/h, it will provide elemental Calcium 1mg/kg/h. High dose vitamin D: Ergocalciferol (Sterogyl) 50,000 - 200,000 IU/day intramuscularly for up to 2 - 3 days. Or Cholecalciferol (Vitamin D3) similar dose. Magne spasmyl 6 - 8 tablets/day, if there is a decrease in magnesium combined Long-term treatment to maintain blood calcium at a low normal level (2.0 - 2.1 mmol/l)
Oral calcium in the form of calcium chloride or gluconate Calcium or Calcium carbonate average dose 1g (2 tablets of 500mg). Vitamin D Supplements: Ergocalciferol (Vitamin D2) oral or intramuscular oil has an extended half-life. Magnesium supplementation: if patients with hypoparathyroidism are suspected of having hypomagnesaemia, cataracts, digestive disorders. Clinical and biochemical monitoring Perform blood calcium, blood phosphorus, urea, blood creatinine quantification. Monitor symptoms related to vitamin D toxicity.
Bổ sung các chất cần thiết để duy trì Calci máu ở mức bình thường thấp
4. Diet for patients with hypoparathyroidism.
When you have hypoparathyroidism, it is best to consult a nutritionist to build a suitable diet. In general, you should pay attention:
Eat calcium-rich foods. Dairy foods, green leafy vegetables, broccoli and foods with added calcium (such as soy milk or breakfast cereals) will help maintain blood levels of this mineral. Eat less phosphorus. You should note to avoid using carbonated soft drinks because they contain phosphorus in the form of phosphoric acid and limit meats, hard cheeses, whole grains. Any questions that need to be answered by a specialist doctor as well as if you want to be examined and treated at Vinmec International General Hospital, you can contact Vinmec Health System nationwide or register online. online HERE.
