Chronic hypoparathyroidism issues show need for screening, treatment
Brain, eye, kidney issues common in those who've had condition a long time
Even with conventional treatment, health complications including the formation of calcium deposits in the brain, cataracts in the eyes, and kidney stones are frequent among people with chronic hypoparathyroidism, especially those who’ve been living with the condition for a long time, according to an analysis of patients at a center in Tunisia.
“Patients with [chronic hypoparathyroidism] receiving conventional treatment are exposed to a considerable risk of neurological, ocular [eye], and renal [kidney] morbidities that seem to be correlated with disease duration,” the researchers wrote in “Long-term complications of permanent hypoparathyroidism in adults: prevalence and associated factors,” which was published in Endocrine.
The researchers said the results “emphasize the importance of regular biological monitoring, screening, and therapeutic patient education in preventing long-term complications among these patients.”
Hypoparathyroidism is marked by low levels of parathyroid hormone, which helps regulate calcium and other nutrients in the blood.
Frequency of complications
Scientists at Rabta University Hospital, Tunisia reviewed data from 58 people with chronic hypoparathyroidism treated at their center between October 2020 and February 2021 to assess how common different types of hypoparathyroidism complications are.
Patients had a mean age of 52.6 and about three-quarters (78%) were women. Consistent with standard treatment guidelines for hypoparathyroidism, the patients were treated with vitamin D and calcium supplements, though the researchers said more than half the patients reported problems with adhering to treatment.
In brain scans, just over half (55%) the patients had abnormal calcium deposits in the brain, a condition sometimes referred to as Fahr syndrome. Most had memory issues associated with calcium buildup, and some had seizures or hallucinations.
The risk of Fahr syndrome was highest in those who’d been living with chronic hypoparathyroidism for more than than 15 years and those who weren’t taking treatments as prescribed, statistical analyses showed.
“In our patients, disease duration [longer than] 15 years and poor adherence to treatment were independent risk factors of Fahr syndrome,” they wrote.
Cataracts, which is a clouding of the eye lens, were found in nearly two-thirds (62%) of patients. Based on statistical analyses, risk factors for cataracts included older age, longer disease duration, and lower blood magnesium levels.
Kidney stones were documented in 12% of patients and were more likely in those with high calcium in their urine. Also, 17% of the patients had chronic kidney failure. They were generally older and had been living with chronic hypoparathyroidism for many years.
The findings highlight the importance of screening for these complications so they can be addressed before they cause serious problems.
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