Dataset Information

Long-term follow-up of patients with hypoparathyroidism.

ABSTRACT:

Context

Despite tremendous interest in hypoparathyroidism, large cohort studies describing typical treatment patterns, laboratory parameters, and rates of complications are lacking.

Objective

Our objective was to characterize the course of disease in a large cohort of hypoparathyroid patients.

Design and setting

We conducted a chart review of patients with permanent hypoparathyroidism identified via a clinical patient data registry. Patients were seen at a Boston tertiary-care hospital system between 1988 and 2009.

Patients

We identified 120 patients. Diagnosis was confirmed by documented hypocalcemia with a simultaneous low or inappropriately normal PTH level for at least 1 yr. Mean age at the end of the observation period was 52 ± 19 (range 2-87) yr, and the cohort was 73% female.

Main outcome measure

We evaluated serum and urine laboratory results and renal and brain imaging.

Results

We calculated time-weighted average serum calcium measurements for all patients. The time-weighted average for calcium was between 7.5 and 9.5 mg/dl for the majority (88%) of patients. Using linear interpolation, we estimated the proportion of time within the target calcium range for each patient with a median of 86% (interquartile range 67-98%). Of those with a 24-h urine collection for calcium (n = 53), 38% had at least one measurement over 300 mg/d. Of those with renal imaging (n = 54), 31% had renal calcifications, and 52% of those with head imaging (n = 31) had basal ganglia calcifications. Rates of chronic kidney disease stage 3 or higher were 2- to 17-fold greater than age-appropriate norms.

Conclusions

Hypoparathyroidism and its treatment carry a large burden of disease. Renal abnormalities are particularly common.

SUBMITTER: Mitchell DM

PROVIDER: S-EPMC3513540 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Long-term follow-up of patients with hypoparathyroidism.

Mitchell Deborah M DM Regan Susan S Cooley Michael R MR Lauter Kelly B KB Vrla Michael C MC Becker Carolyn B CB Burnett-Bowie Sherri-Ann M SA Mannstadt Michael M

The Journal of clinical endocrinology and metabolism 20121005 12

<h4>Context</h4>Despite tremendous interest in hypoparathyroidism, large cohort studies describing typical treatment patterns, laboratory parameters, and rates of complications are lacking.<h4>Objective</h4>Our objective was to characterize the course of disease in a large cohort of hypoparathyroid patients.<h4>Design and setting</h4>We conducted a chart review of patients with permanent hypoparathyroidism identified via a clinical patient data registry. Patients were seen at a Boston tertiary-c ...[more]

PMID: 23043192

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Project description:Background and objectiveErythropoietin (EPO) is a candidate neuroprotective drug. We assessed its long-term safety and efficacy as an adjunct to methylprednisolone in patients with optic neuritis and focused on conversions to multiple sclerosis (MS).MethodsThe TONE trial randomized 108 patients with acute optic neuritis but without previously known MS to either 33,000 IU EPO or placebo in conjunction with 1,000 mg methylprednisolone daily for 3 days. After reaching the primary end point at 6 months, we conducted an open-label follow-up 2 years after randomization.ResultsThe follow-up was attended by 83 of 103 initially analyzed patients (81%). There were no previously unreported adverse events. The adjusted treatment difference of peripapillary retinal nerve fiber layer atrophy in relation to the fellow eye at baseline was 1.27 µm (95% CI -6.45 to 8.98, p = 0.74). The adjusted treatment difference in low-contrast letter acuity was 2.87 on the 2.5% Sloan chart score (95% CI -7.92 to 13.65). Vision-related quality of life was similar in both treatment arms (National Eye Institute Visual Functioning Questionnaire median score [IQR]: 94.0 [88.0 to 96.9] in the EPO and 93.4 [89.5 to 97.4] in the placebo group). The rate of multiple sclerosis-free survival was 38% in the placebo and 53% in the EPO group (hazard ratio: 1.67, 95% CI 0.96 to 2.88, p = 0.068).DiscussionIn line with the results at 6 months, we found neither structural nor functional benefits in the visual system of patients with optic neuritis as a clinically isolated syndrome, 2 years after EPO administration. Although there were fewer early conversions to MS in the EPO group, the difference across the 2-year window was not statistically significant.Classification of evidenceThis study provides Class II evidence that for patients with acute optic neuritis, EPO as an adjunct to methylprednisolone is well tolerated and does not improve long-term visual outcomes.Trial registration informationThe trial was preregistered before commencement at clinicaltrials.gov (NCT01962571).

Dataset Information

Long-term follow-up of patients with hypoparathyroidism.

Context

Objective

Design and setting

Patients

Main outcome measure

Results

Conclusions

Publications

Long-term follow-up of patients with hypoparathyroidism.

Similar Datasets

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