Clinical Features And Prognosis Of 33 Children With Hypoparathyroidism

Objective:The aim of this study was to calculate the patients of hypoparathyroidism diagnosed in Shengjing Hospital of China Medical University,and to analyze the clinical features and treatment plan,in order to guide clinical diagnosis and threapy,reduce mis diagnosis and to raise awareness of the disease.Methods:In this study,we retrospectively reviewed 33 cases with hypoparathyroidism diagnosed in Shengjing Hospital of China Medical University from April,2012 to January 2019.According to the different etiology,they were divided into two groups: hypoparathyroidism(group A)and pseudohypoparathyroidism(group B).Retrospective analysis of clinical data,including clinical features(gender,age,symptoms,course of disease,physical examination,etc.),auxiliary examination(calcium,magnesium,PTH,24-hour urinary calcium,electrocardiogram,CT or MRI,EEG,etc.).Analyse the clinical characteristics,diagnosis,treatment process and the follow-up survey.Results: In this study,24 cases were male(72.7%)and 9 were female(27.3%).17 cases were hypoparathyroidism(14 males and 3 females),including 1 Di George syndrome.16 cases were pseudohypoparathyroidism(10 males and 6 females).Clinical manifestations are complex and diverse.14cases(42.4%)were convulsions,18 cases(54.5%)were hand and foot palsy,12 cases(36.4%)were abnormal(numbness),3 cases(9.1%)were diagnosed with epilepsy,and 3 cases(9.1%)were accompanied by symptoms of gastrointestinal symptoms(diarrhea or constipation).Laboratory tests for hypocalcemia,hyperphosphatemia was the most common(33 cases),serum parathyroid hormone can be reduced or elevated.There was no significant difference in mean serum calcium and blood phosphorus between the two groups(P>0.05).The 24-hour urinary calcium was statistically different(P<0.05),but there was no significant difference in 24-hour urinary phosphorus(P>0.05).In group A,17 patients,17 underwent head imaging(CT or MRI),and 10 patients with head calcification(58.8%).Fifteen patients in group B underwent head imaging and 13cases(81.2%)of head calcification.There were no statistical differences in the imaging changes between the two groups(P>0.05).Symptoms were improved after calcium supplementation and active vitamin D in patients with hypoparathyroidism.There was no significant difference between the two groups in the dose and the number of treatment days(P>0.05).Conclusion: Hypoparathyroidism has a variety of clinical manifestations.Early diagnosis and timely treatment are especially important.The goal of treatment is to use a minimum dose of calcium and vitamin D to maintain blood calcium at normal low values.