MON-528 Hypoparathyroidism in a Medium-Income Country Shares Similar Clinical Profile to High Income Countries

Abstract

Abstract Introduction Hypoparathyroidism is a rare disease. In low and medium-income countries there is limited data of clinical characteristics and patterns of clinical practice of patients with hypoparathyroidism. Methods Observational cross-sectional study in a tertiary care university hospital in Colombia. The clinical charts of adult patients with diagnosis of hypoparathyroidism were included. Inclusion criteria were a diagnosis of hypoparathyroidism with a PTH less than 20 pg/mL associated with hypocalcemia. Major results 108 patients fulfilled inclusion criteria. 91.7% (n=99) were women and 8.3% (n=9) were men. Mean age was 51.6 years (SD 15.5). 99.1% of patients were Hispanic and 0.9% were African American. Comorbidities were HTN in 42.6%, CAD in 3.7%, DM2 in 6.5%, dyslipidemia in 21.3%, PAD in 5.6%, Afib in 1.9%, stroke in 2.8%, valve heart disease in 0.9%, hypothyroidism in 88.9%, and thyroid cancer in 51.9% The etiology of hypoparathyroidism was postsurgical (93.5%), followed by idiopathic hypoparathyroidism (4.6%), post-radiation (0.9%), and unknown causes in (0.9%). Mental illness was found in 16.7% of cases, osteo-muscular compromise in 27.8%, carpo-pedal spam was referred by 15.7% of patients, and paresthesia in 35.2%. Seizures were reported by 9.3% of patients and basal ganglia calcification was found in 5.6% of cases. Trousseau sign was reported in 13% of cases and Chvostek in 6.5%. Initial calcium was 7.8 mg/dL (SD 1.8), the mean lowest calcium was 7.2 mg/dL SD 1.5, the last known urinary calcium was 237.4 mg/day (SD 48.08). However, it was only measured in 20 patients. The mean PTH level was 6.9 pg/ml (SD 0.54). Nephrocalcinosis was found in 2.8% of cases and nephrolithiasis in 3.7%. Patients required a mean of 0.7 emergency room consults, however, the range was wide from 0 to 21 consults. Median elemental calcium dose at last control was 960 mg/day (p25-p75 480-1440), median calcitriol dose was 0.5 ug/day (p25-p75 0.5-1.0). However, 13.8% of patients required more than 2000 mg/day of elemental calcium. PTH analogs were used in 1.9% of cases (n=2). Biochemical control of the disease was achieved in 50% of patients. Interpretation of the results and conclusions Our data suggest that patients with hypoparathyroidism from a medium income country share a similar clinical profile with patients from high-income countries. However, the biochemical control of the disease is low. Post-surgical hypoparathyroidism is the most common cause of hypoparathyroidism (93.6%) and its frequency is higher than other countries (75%), this suggests limitations in surgical performance or decreased detection of other rare etiologies. This study present for first time systematic data in Colombia and is one of the first studies in medium income countries.