Abstract:
Hypoparathyroidism is a rare disorder characterized by the absent or inappropriately decreased serum parathyroid hormone in the parathyroid glands, which is accompanied by impaired calcium-phosphorus metabolism.The main etiology of hypoparathyroidism remains damage or removal of the parathyroid glands during neck surgery. In view of the incidence of thyroid cancer, primary hyperparathyroidism and other pathologies of the neck organs, which radical treatment can lead to the parathyroid gland impairment, an increased number of patients with hypoparathyroidism is expected. Autoimmune hypoparathyroidism is the second most common form of the disease, usually occurring as part of type 1 autoimmune polyglandular syndrome. Autoimmune hypoparathyroidism usually occurs in childhood and is characterized by a severe course of the disease, especially in the case of concomitant malabsorption syndrome.Chronic hypoparathyroidism of any etiology requires lifelong multicomponent therapy, as well as careful monitoring and an individual approach to choose the optimal treatment strategy. In the absence of adequate follow-up, the risks of long-term complications significantly increase, particularly in the renal, cardiovascular systems; in the soft tissues and in the brain, it could lead to visual disturbances; pathology of the musculoskeletal system with a decreased bone remodeling and a potential risk of fractures, as well as to the neurocognitive disorders and an impaired health-related quality of life.Timely diagnosis, rational medical therapy and management strategy may reduce the risks of short-term and long-term complications, frequency of hospitalizations and disability of patients, as well as improve the prognosis.This review covers the main issues of Russian guidelines for the management of chronic hypoparathyroidism, approved in 2021, including laboratory and instrumental evaluation, treatment approaches and follow-up. This guidelines also include the recommendations for special groups of patients: with acute hypocalcemia, hypoparathyroidism during pregnancy.
摘要:
甲状旁腺功能减退症是一种罕见的疾病,其特征是甲状旁腺中的血清甲状旁腺激素缺乏或不适当地降低。伴随着钙磷代谢受损。甲状旁腺功能减退的主要病因仍然是颈部手术中甲状旁腺的损伤或切除。鉴于甲状腺癌的发病率,原发性甲状旁腺功能亢进和颈部器官的其他病理,哪种根治性治疗可以导致甲状旁腺受损,预计甲状旁腺功能减退症患者数量会增加.自身免疫性甲状旁腺功能减退症是该疾病的第二常见形式,通常作为1型自身免疫性多腺体综合征的一部分发生。自身免疫性甲状旁腺功能减退症通常发生在儿童时期,其特点是病程严重,特别是在伴随吸收不良综合征的情况下。任何病因的慢性甲状旁腺功能减退症都需要终身的多成分治疗,以及仔细的监测和个人的方法来选择最佳的治疗策略。在缺乏充分的后续行动的情况下,长期并发症的风险显着增加,特别是在肾脏,心血管系统;在软组织和大脑中,它可能导致视觉障碍;肌肉骨骼系统的病理学,骨重塑减少和骨折的潜在风险,以及神经认知障碍和与健康相关的生活质量受损。及时诊断,合理的药物治疗和管理策略可以降低短期和长期并发症的风险,患者住院和残疾的频率,以及改善预后。这篇综述涵盖了俄罗斯慢性甲状旁腺功能减退症治疗指南的主要问题,2021年批准,包括实验室和仪器评估,治疗方法和随访。该指南还包括针对特殊患者组的建议:急性低钙血症,怀孕期间甲状旁腺功能减退。