Krysiak Robert, Handzlik-Orlik Gabriela, Kedzia Agnieszka, Machnik Grzegorz, Okopień Bogusław
Klinika Chorób Wewnetrznych i Farmakologii Klinicznej, Katedra Farmakologii, Slaski Uniwersytet Medyczny w Katowicach.
Wiad Lek. 2013;66(1):18-29.
Hypoparathyroidism is a result of reduced secretion or impaired action of parathyroid hormone (PTH). Although considered a rare condition, hypoparathyroidism seems to occur much more frequently than reported. In most cases, hypoparathyroidism remains a complication of neck surgery. However, there is a growing incidence of the autoimmune form of hypoparathyroidism, which may occur in combination with other autoimmune diseases. As parathyroid glands are necessary to sustain life and maintain homeostasis, undetected or misdiagnosed hypoparathyroidism may pose a significant threat to health outcomes, as its presence may increase morbidity and mortality in affected individuals. The clinical consequences of PTH deficiency or impaired receptor action are multidirectional and include nervous hyperexcitability, paresthesias, cramps, tetany, hyperreflexia, convulsions, cataract, weakened tooth enamel, brittle nails and basal ganglia calcifications. In some patients, however, its manifestation may be non-specific, and in these cases the correct diagnosis may be easily missed. Laboratory measurements show hypocalcemia, hyperphosphatemia, and, with the exception of pseudohypoparathyroidism, inappropriately low or undetectable PTH levels. Treatment consists of oral calcium supplementation and vitamin D derivatives. In this review article, we discuss the causes, clinical picture, diagnosis and treatment of hypoparathyroidism and provide the reader with some practical guidance concerning dealing with a patient suffering from this disorder.
甲状旁腺功能减退症是甲状旁腺激素（PTH）分泌减少或作用受损的结果。尽管甲状旁腺功能减退症被认为是一种罕见病症，但它的实际发生率似乎比报告的要高得多。在大多数情况下，甲状旁腺功能减退症仍是颈部手术的并发症。然而，自身免疫性甲状旁腺功能减退症的发病率正在上升，它可能与其他自身免疫性疾病同时发生。由于甲状旁腺对于维持生命和体内平衡至关重要，未被发现或误诊的甲状旁腺功能减退症可能对健康结果构成重大威胁，因为它的存在可能增加受影响个体的发病率和死亡率。PTH缺乏或受体作用受损的临床后果是多方面的，包括神经兴奋性增高、感觉异常、痉挛、手足搐搦、反射亢进、惊厥、白内障、牙釉质减弱、指甲变脆和基底神经节钙化。然而，在一些患者中，其表现可能不具有特异性，在这些情况下可能很容易漏诊。实验室检查显示低钙血症、高磷血症，除假性甲状旁腺功能减退症外，PTH水平异常低或检测不到。治疗包括口服补钙和维生素D衍生物。在这篇综述文章中，我们讨论了甲状旁腺功能减退症的病因、临床表现、诊断和治疗，并为读者提供了一些处理患有这种疾病患者的实用指导。
