Hypoparathyroidism as an Autoimmune Disease

Hypoparathyroidism is a rare disease in which the parathyroid glands (four small glands in the neck) cannot produce an important hormone called the parathyroid hormone (PTH). This hormone regulates levels of calcium and phosphate in the blood, among many other duties.

Autoimmune diseases can sometimes cause hypoparathyroidism.

What is an autoimmune disease?

Your immune system protects you from infection and disease. Immune cells called B-cells produce antibodies against threats like viruses and bacteria. Other immune cells bind to the antibodies — which have bound to threats — and act to destroy the invader.

In autoimmune diseases, the immune system produces antibodies against the body’s own systems and tissues.

Many types of autoimmune disease are known, and having any one of them makes it more likely that you will develop at least one other.

Autoimmune disease and hypoparathyroidism

Hypoparathyroidism can occur as part of a larger autoimmune disease called autoimmune polyendocrine syndrome type 1 (APS1), which damages organs. Not all patients with APS1 develop hypoparathyroidism, but some do. Mutations in an immune regulatory gene called AIRE are associated with a recessive form of APS1.

Some people have autoimmune hypoparathyroidism with no other symptoms. This is sometimes called idiopathic autoimmune hypoparathyroidism, because the cause is unknown.

How is autoimmune hyperparathyroidism treated?

Treatments for hypoparathyroidism depend on a person’s symptoms. Most commonly, doctors treat patients with special vitamin D and calcium supplements. In severe cases, they administer these supplements directly into the bloodstream, instead of prescribing tablets.

A medication, called Natpara, marketed by Takeda Pharmaceuticals, is available that contains artificially created PTH hormone. The U.S. Food and Drug Administration (FDA) approved this treatment only for patients whose calcium levels cannot be controlled with supplement use. Natpara is administered as a subcutaneous (under the skin) injection, and most patients learn to do this themselves at home.