Pediatric hypoparathyroidism

What is pediatric hypoparathyroidism?

The parathyroid gland is made up of four tiny glands located just behind the thyroid in the neck. The parathyroid hormone controls the body’s calcium, phosphorous and Vitamin D levels. When the calcium level in a child’s body drops, the parathyroid gland releases the parathyroid hormone. Once the calcium levels have returned to normal in the bloodstream, the parathyroid glands should be signaled to stop producing the hormone.

In hypoparathyroidism, the parathyroid glands don’t receive the signal and continue to produce the hormone, which in turn creates high levels of calcium in the child’s body. Consistently high levels of calcium can have an impact on the child’s metabolism, kidneys and bones.

What are the signs and symptoms of pediatric hypoparathyroidism?

Hypoparathyroidism is typically diagnosed before the child begins experiencing symptoms.

If symptoms are present:

• Anxiety or depression

• Brittle, easily broken nails

• Decreased appetite

• Dry, coarse skin

• Fatigue

• Forgetfulness

• Fragile bones

• Headaches

• Increased frequency/production of urine

• Muscle aches and cramps in the legs, feet, abdomen or face

• Nausea

• Painful menstruation in her teens

• Patches of hair loss

• Tingling or burning in your child’s fingertips, toes and lips

• Twitching muscles around the mouth, hands, arms and throat

How is pediatric hypoparathyroidism diagnosed?

The first step in diagnosing hypoparathyroidism is taking a medical history. Your child’s doctor will ask about symptoms such as cramps or tingling in the hands and feet, or twitching of the muscles of the face. They will also ask about any recent surgeries that may have involved the head and neck.

Tests may include:

• Blood test (calcium level, PTH or magnesium)

• Urinalysis

If cancer is suspected:

• Sestamibi scan - This uses a small amount of a radioactive substance that collects in the gland, can determine which gland is abnormal

• CT scan

• Ultrasound

What are the causes of pediatric hypoparathyroidism?

Hypoparathyroidism can be caused by certain medical conditions that result in low blood calcium, including:

• Low calcium diet

• High amounts of calcium lost in urine

• Issues absorbing food nutrients

• Kidney failure

• Vitamin D disorders

How is pediatric hypoparathyroidism treated?

The treatment of hypoparathyroidism differs from the treatment of similar diseases of the endocrine glands. The goal is to restore calcium, magnesium and phosphorous levels to normal. At present, there is no approved replacement for the hormone itself.

The only therapies currently approved for use are synthetic forms of vitamin D and calcium, in addition to taking calcium and magnesium supplements. Some children may be encouraged to eat foods that are high in calcium such as dairy, breakfast cereals, fortified orange juice or leafy green vegetables. They also should avoid foods and beverages that are high in phosphorous, such as carbonated soft drinks, eggs and meat.

The physician treating your child will keep a close eye on the levels of calcium and phosphorous in the blood during the early stages. After the proper balance has been restored, the tests will be done less often.