Abstract
ABSTRACTIn hypoparathyroidism (HypoPT), patients suffer severely from reduced quality of life. The complexity of HypoPT demands a disease‐specific control instrument to characterize symptom load. We employed a newly developed disease‐specific Hypoparathyroid Patient Questionnaire (the HPQ 40/28) to investigate and quantify HypoPT patients' complaints and contributing factors. In this cross‐sectional, two‐center study, patients with postsurgical HypoPT (n = 49) were matched for gender and age and compared with patients having undergone thyroid surgery without HypoPT (n = 39) and patients with primary hyperparathyroidism (n = 35). The HPQ 40/28 was completed when patients visited the respective center. Clinical background information, blood tests, and current medication were documented by the physician. Serum calcium lay within the reference range in 87% of HypoPT patients, serum phosphate in 95.7%, and calcium–phosphate product (CPP) in 100%. HPQ 40/28 scores for the scales “pain and cramps” (PaC), “neurovegetative symptoms” (NVS), “numbness or tingling,” and “heart palpitations” were significantly elevated in comparison with control groups. Correlations between complaints and laboratory parameters could be demonstrated in the HypoPT group, with serum calcium correlating with NVS (r = 0.309, p < 0.05) and serum phosphate with loss of vitality (r = 0.349, p < 0.05). CPP was the main contributor to symptom load with an influence on PaC (r = 0.295, p < 0.05), loss of vitality (r = 0.498, p < 0.001), numbness or tingling (r = 0.328, p < 0.05), and memory problems (r = 0.296, p < 0.05). In conclusion, the newly developed HPQ 40/28 successfully identified and quantified symptoms typical in HypoPT patients. Using the HPQ 40/28, the CPP was identified as the predominant factor in the severity of complaints in HypoPT. © 2020 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
Highlights
Hypoparathyroidism (HypoPT) is a disease characterized by hypocalcemia and hyperphosphatemia resulting from the absence or inappropriately low levels of PTH
The specificity we reached was 0.5; this implies that 50% of those with low symptom load are above this value of 2.5 mmol2/L2. This 1-year cross-sectional study aimed to validate the use of the HPQ 40/28 as a specific questionnaire to explore the symptoms and complaints of HypoPT patients
We examined 123 patients, including 49 with postsurgical HypoPT, 39 thyroid surgery without HypoPT (ThySu) patients, and 35 patients with primary hyperparathyroidism (pHPT)
Summary
Hypoparathyroidism (HypoPT) is a disease characterized by hypocalcemia and hyperphosphatemia resulting from the absence or inappropriately low levels of PTH. The current method does not restore the physiologic status and is hampered by the occurrence of potentially serious complications, such as renal and 1 of 10 n basal ganglia calcifications, cataracts, and premature chronic kidney dysfunction.[4,5,6] Previous studies on disease characterization using conventional treatment revealed an increased risk of hospitalization as a result of infection, neuropsychiatric disease,(7) abnormal bone architecture,(8–10) and impaired muscle function.[11] Lately, an increase in mortality has been found.[6] Quality of life (QoL) has been reduced in patients with HypoPT compared with both the normal population and patients undergoing thyroid surgery.[2,11,12,13]. The defined level of control was based mainly on achieving the target range for serum calcium levels. This has changed to include multiple biochemical parameters beyond serum calcium, including serum phosphate, calcium– phosphate product (CPP), magnesium, and urinary calcium excretion.[14,15]
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