Hypoparathyroidism in Children
Hypoparathyroidism is very uncommon in children, given the average age of disease onset is about 43. But it’s not unknown.
Here is some information about the causes, treatment, and likely duration of hypoparathyroidism in young patients.
What is hypoparathyroidism?
Hypoparathyroidism is a rare condition in which the body produces abnormally low levels of parathyroid hormone (PTH). PTH is key to regulating and maintaining a balance of two minerals in the body — calcium and phosphorus.
Low PTH levels due to hypoparathyroidism lead to abnormally low calcium levels in the blood and bones, and an increase in phosphorus levels in the blood.
What causes it?
In adults, about 75% of cases are due to neck surgery, typically for thyroid, parathyroid, or other head or neck disorder that damages (or removes) the parathyroid glands.
In children and adolescents, hypoparathyroidism is typically due to genetics. A baby can be born with no parathyroid glands. In some cases, the cause of the disease is unknown.
A recent study found that thyroid cancer, central neck surgery, and the incidental removal of parathyroid tissue in a surgery to remove the thyroid glands raised the risk of hypoparathyroidism in children, much as it does in adults.
Who is at risk?
A child is at risk of hypoparathyroidism if he or she has had surgery on the neck or thyroid gland, has an autoimmune disease, was born prematurely, or has a family history of the disease.
What are the symptoms?
Although they can vary among children, symptoms of hypoparathyroidism can include:
- numbness around the mouth or in hands and feet
- uncontrollable and painful spasms in the face, hands, arms, and feet
- low blood pressure
- anxiety or depression
- dental problems
- coarse and brittle hair
How is this disease diagnosed in children?
Your physician will inquire about your child’s symptoms and health history, and likely your family’s health history. Your child will undergo a physical exam, and tests to measure blood levels of salts and PTH.
Is the disease lifelong in children?
Congenital hypoparathyroidism that occurs during the first few months of life may be temporary (transient) or permanent (lifelong).
The study about hypoparathyroidism in children after thyroidectomy (removal of the thyroid gland) found the risk of permanent disease to be low, with two of this study’s 68 children (3%) developing permanent disease. For most, parathyroid function returned within a year.
How do doctors treat these children?
Treatment and management can be challenging, particularly in infants, since vitamin D dosages must be adjusted and monitored to minimize the risk of nephrocalcinosis (calcium deposits in the kidneys) and nephrolithiasis (kidney stones).
For children who don’t respond to conventional therapy — calcium and vitamin D supplements — PTH replacement therapy may represent a treatment option. At least one study has demonstrated that such treatment is safe and effective in maintaining stable calcium homeostasis in children with the disease.
Last updated: Oct. 2, 2020
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