Must to Know about Hypoparathyroidism (Part-1)

Hypoparathyroidism কে আমরা তিন ভাগে ভাগ করতে পারি-
1. Primary Hypoparathyroidism
2. Pseudohypoparathyroidism (PHP)
3. Pseudopseudohypoparathyroidism (PPHP)

আজকে আমরা Primary Hypoparathyroidism সম্পর্কে জানব।

Cause of Primary Hypoparathyroidism :

1. Surgery – (Thyroidectomy, Radical neck surgery)
2. Congenital –
a) DiGeorge syndrome-
– Decreased PTH (Parathyroid hormone)
– Decreased Cell mediated immunity.
b) Polyglandular autoimmune type 1 deficiency – due to mutation of a stop codon.
– Decreased PTH
– Decreased Adrenalgland secretion
– Chronic muco-cutaneous candidiasis
– Failure of ovary
– Decreased Immune function
– Pernicious anaemia
3. Idiopathic Hypoparathyroidism
4. Autosomal Dominant hypocalcemic hypercalciuria
5. Rarely in Hemochromatosis and Wilson’s Disease.

Clinical feature :

Parathyroid gland আমাদের body তে calcium এর level maintain করে। তাই, PTH যদি কমে যায় তাহলে calcium level ও কমে যাবে। So, আমরা hypocalcemia এর feature পাবো। তাহলে কি সেটা?

a. Mild hypocalcemia এর feature নাই – asymptomatic।
b. কিন্তু যদি severe হয় –
calcium এর একটা কাজ হলো calcium আমাদের cell এ Na এর permeability maintain করে।

Decreased Ca level


Increased Na permeability


Increased depolarization


Nerves become hyperexcitable


Features of tetany –
– Circumoral numbness
– Tingling in finger
Carpopedal spasm : Flexion of Metacarpophalangeal joint and adduction of thumb (Specially in inflation of sphygmomanometer cuff on upper arm to more than systolic blood pressure it is known as Trousseau’s sign)
Chvostek’s sign : Tapping over the parotid gland produces twitching of facial muscle.
– Laryngospasm

Other features –
– Generalised seizure
– Emotional instability
– In ECG – Prolonged QT interval
– In prolonged case – Calcification in basal ganglia, Epilepsy, Psychosis, Cataracts.
– Hypomagnesaemia.


1. Serum PTH – Decreased
2. Serum Calcium – Decreased, Serum Phosphate – Increased
3. ECG – Prolonged QT interval
4. CT (Computerized tomography) scan, MRI (Magnetic resonance Imaging) – to see calcification.


1. Vitamin analogues – calcitriol
2. Calcium gluconate
In severe hypocalcemia – 10-20 ml over 10-20 minutes.
3. If hypomagnesaemia occurs – IV magnesium chloride (50 ml over 24 hours)

মেজবাহ উদ্দিন
রাজশাহী মেডিকেলে কলেজ
সেশনঃ ২০১৫-২০১৬

প্ল্যাটফর্ম একাডেমিক / নাসিম পারভেজ

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