Complications
Complications of parathyroid hypothyroidism occur mainly when the parathoromone deficiency is not detected in time. In children this can lead to dental anomalies, developmental disorders and dwarfism. In adults, late damage from parathyroid hormone deficiency can occur if it is not detected early and treated with medication.
These include heart problems, cataracts, osteoporosis and calcification of the basal ganglia in the brain. This leads to the so-called Fahr syndrome. Clinical signs are headaches, speech disorders and slowly progressing dementia.
Often the clinical picture of parathyroid hypofunction in connection with the medical history leads to a suspected diagnosis of hypoparathyroidism. Subsequent laboratory diagnostics then provide the evidence and confirm the diagnosis. A decreased serum calcium level should always be the reason for the determination of parathyroid hormone levels.
In the case of pure hypocalcaemia, the parathyroid hormone level would be reactively elevated to provide the body with more calcium. However, if the parathyroid glands are surgically removed or otherwise damaged, not only the calcium level but also the parathyroid hormone level is lowered, thus ensuring the diagnosis of hypoparathyroidism (hypothyroidism). If congenital hypoparathyroidism (hypothyroidism) is not detected in children, dental abnormalities and dwarfism may be the result of this deficiency.
Computer tomography should be performed to exclude calcifications in the brain that have already developed. An ECG is also important for estimating the extent of the problem, in order to be able to rule out involvement of the heart. The aim of drug therapy of parathyroid hypothyroidism is to maintain a normal blood calcium level.
Dihydrotachysterol or Rocaltrol are often used as vitamin D analogues in combination with calcium to maintain the calcium level. Since too high a calcium level can lead to increased calcium excretion in the urine, calcium should be checked regularly in the case of parathyroid hypothyroidism. Otherwise, kidney stones or nephrocalcinosis can be the result of excessive calcium in the urine.
To avoid these side effects, a thiazide diuretic can be prescribed at the same time as calcium. This lowers the calcium level in the urine, thus preventing the risk of kidney stone formation.This mirror should also be checked regularly. In the acute therapy of a tetanic seizure, intravenous calcium administration is the treatment of choice.
The injection should be administered as slowly as possible, because otherwise the patient will react to the calcium administration with a feeling of heat, nausea and headaches. Tetanic spasms can be well treated by lifelong calcium substitution. However, late effects such as calcification or cataract are irreversible and cannot be treated by calcium substitution.
