Treatment
Severe hypocalcemia, a potentially life-threatening condition, is treated as soon as possible with intravenous calcium (e.g. as calcium gluconate). Generally, a central venous catheter is recommended, as the calcium can irritate peripheral veins and cause phlebitis. In the event of a life-threatening attack of low calcium levels or tetany (prolonged muscle contractions), calcium is administered by intravenous (IV) infusion. Precautions are taken to prevent seizures or larynx spasms. The heart is monitored for abnormal rhythms until the person is stable. When the life-threatening attack has been controlled, treatment continues with medicine taken by mouth as often as four times a day.
Long-term treatment of hypoparathyroidism is with vitamin D analogs and calcium supplementation may be ineffective in some due to potential renal damage. The N-terminal fragment of parathyroid hormone (PTH 1-34) has full biological activity. The use of pump delivery of synthetic PTH 1-34 provides the closest approach to physiologic PTH replacement therapy. Teriparatide, a recombinant form of PTH (presently registered for osteoporosis) might become the treatment of choice for PTH supplementation. Currently, hypoparathyroidism is the only hormonal insufficiency state that does not have a hormone-replacement-therapy approved, but research is being conducted to establish recombinant human parathyroid hormone (1-84) (rhPTH) as just such a replacement.
Read more about this topic: Hypoparathyroidism
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