Short-Term PTH(1-34) Therapy in Children to Correct Severe Hypocalcemia and Hyperphosphatemia due to Hypoparathyroidism: Two Case Studies
The standard treatment of hypoparathyroidism is to control hypocalcemia using calcitriol and calcium supplementation. However, in severe cases this approach is insufficient, and the risks of intravenous (i.v.) calcium administration and prolonged hospitalization must be considered. While the use of...
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Wiley
2016-01-01
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| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2016/6838626 |
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| author | Pooja E. Mishra Betsy L. Schwartz Kyriakie Sarafoglou Kristen Hook Youngki Kim Anna Petryk |
| author_facet | Pooja E. Mishra Betsy L. Schwartz Kyriakie Sarafoglou Kristen Hook Youngki Kim Anna Petryk |
| author_sort | Pooja E. Mishra |
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| description | The standard treatment of hypoparathyroidism is to control hypocalcemia using calcitriol and calcium supplementation. However, in severe cases this approach is insufficient, and the risks of intravenous (i.v.) calcium administration and prolonged hospitalization must be considered. While the use of recombinant human parathyroid hormone 1-34 [rhPTH(1-34)] for long-term control of hypocalcemia has been established, the benefits of short-term rhPTH(1-34) treatment in children have not been explored. We report two patients with hypoparathyroidism treated with rhPTH(1-34). Patient 1 is a 10-year-old female with polyglandular autoimmune syndrome type 1. Patient 2 is a 12-year-old female with hypoparathyroidism after total thyroidectomy. Both patients showed poor response to i.v. and oral calcium and calcitriol, and patient 1 did not respond to phosphate binders. Patient 1 had rapid increase in serum calcium with a decrease in serum phosphate after a 3-day course of subcutaneous rhPTH(1-34). Patient 2 had normalization of calcium and phosphate levels after a 7-day course of rhPTH(1-34). These cases support a role for rhPTH(1-34) in the acute management of hypoparathyroidism in hospitalized patients to more rapidly correct hypocalcemia and hyperphosphatemia, shorten hospitalization, and reduce the need for frequent i.v. calcium boluses. |
| format | Article |
| id | doaj-art-1eb29eb37cbe448ba2c183b65d8e5eed |
| institution | OA Journals |
| issn | 2090-6501 2090-651X |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
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| series | Case Reports in Endocrinology |
| spelling | doaj-art-1eb29eb37cbe448ba2c183b65d8e5eed2025-08-20T02:03:47ZengWileyCase Reports in Endocrinology2090-65012090-651X2016-01-01201610.1155/2016/68386266838626Short-Term PTH(1-34) Therapy in Children to Correct Severe Hypocalcemia and Hyperphosphatemia due to Hypoparathyroidism: Two Case StudiesPooja E. Mishra0Betsy L. Schwartz1Kyriakie Sarafoglou2Kristen Hook3Youngki Kim4Anna Petryk5St John’s Medical College, Bangalore, IndiaPediatric Endocrinology, Park Nicollet, Minneapolis, MN, USAPediatric Endocrinology, University of Minnesota, Minneapolis, MN, USAPediatric Dermatology, University of Minnesota, Minneapolis, MN, USAPediatric Nephrology, University of Minnesota, Minneapolis, MN, USAPediatric Endocrinology, University of Minnesota, Minneapolis, MN, USAThe standard treatment of hypoparathyroidism is to control hypocalcemia using calcitriol and calcium supplementation. However, in severe cases this approach is insufficient, and the risks of intravenous (i.v.) calcium administration and prolonged hospitalization must be considered. While the use of recombinant human parathyroid hormone 1-34 [rhPTH(1-34)] for long-term control of hypocalcemia has been established, the benefits of short-term rhPTH(1-34) treatment in children have not been explored. We report two patients with hypoparathyroidism treated with rhPTH(1-34). Patient 1 is a 10-year-old female with polyglandular autoimmune syndrome type 1. Patient 2 is a 12-year-old female with hypoparathyroidism after total thyroidectomy. Both patients showed poor response to i.v. and oral calcium and calcitriol, and patient 1 did not respond to phosphate binders. Patient 1 had rapid increase in serum calcium with a decrease in serum phosphate after a 3-day course of subcutaneous rhPTH(1-34). Patient 2 had normalization of calcium and phosphate levels after a 7-day course of rhPTH(1-34). These cases support a role for rhPTH(1-34) in the acute management of hypoparathyroidism in hospitalized patients to more rapidly correct hypocalcemia and hyperphosphatemia, shorten hospitalization, and reduce the need for frequent i.v. calcium boluses.http://dx.doi.org/10.1155/2016/6838626 |
| spellingShingle | Pooja E. Mishra Betsy L. Schwartz Kyriakie Sarafoglou Kristen Hook Youngki Kim Anna Petryk Short-Term PTH(1-34) Therapy in Children to Correct Severe Hypocalcemia and Hyperphosphatemia due to Hypoparathyroidism: Two Case Studies Case Reports in Endocrinology |
| title | Short-Term PTH(1-34) Therapy in Children to Correct Severe Hypocalcemia and Hyperphosphatemia due to Hypoparathyroidism: Two Case Studies |
| title_full | Short-Term PTH(1-34) Therapy in Children to Correct Severe Hypocalcemia and Hyperphosphatemia due to Hypoparathyroidism: Two Case Studies |
| title_fullStr | Short-Term PTH(1-34) Therapy in Children to Correct Severe Hypocalcemia and Hyperphosphatemia due to Hypoparathyroidism: Two Case Studies |
| title_full_unstemmed | Short-Term PTH(1-34) Therapy in Children to Correct Severe Hypocalcemia and Hyperphosphatemia due to Hypoparathyroidism: Two Case Studies |
| title_short | Short-Term PTH(1-34) Therapy in Children to Correct Severe Hypocalcemia and Hyperphosphatemia due to Hypoparathyroidism: Two Case Studies |
| title_sort | short term pth 1 34 therapy in children to correct severe hypocalcemia and hyperphosphatemia due to hypoparathyroidism two case studies |
| url | http://dx.doi.org/10.1155/2016/6838626 |
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