Recombinant Parathyroid Hormone Infusion in the Management of Childhood Hypoparathyroidism.


Dr Swati Bhave    13 October 2017

Hypoparathyroidism associated with malabsorption can be particularly challenging to manage due to limited and erratic intestinal absorption of calcium and vitamin D analogues resulting in episodes of hypo or hyper calcemia. A new article published in Hormone Research in Paediatrics evaluated the role of continuous subcutaneous recombinant parathyroid hormone rhPTH 1 34 infusion CSPI in children with hypoparathyroidism associated with intestinal malabsorption resistant to conventional therapy. Here four patients in the age group of 8 13 years with symptomatic hypo calcemia resistant to conventional therapy were started on CSPI. It was found that serum calcium of these children normalized within 48 hours of initiation the treatment. Additionally an average rhPTH 1 34 dose of 0.4 g kg day resulted in a considerable reduction in symptomatic hypocalcemia and hypo hyper calcemia related hospital admissions. An increased alkaline phosphatase activity was noted in the first six months on CSPI indicating an increase in bone turnover. Furthermore elevated urinary calcium excretion before CSPI normalized in two patients within the first year on treatment. Moreover significant side effects were absent in the short or long term with patient reported preference of CSPI over conventional treatment. Thus it was inferred that CSPI is a promising and effective treatment option for managing hypo calcemia and hyper phosphatemia in children with hypoparathyroidism associated with intestinal malabsorption.

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