REVIEW

Primer Hipoparatiroidizm, Güncel Tedavisi ve Erişkin Hastalarda Parathormon Analoglarının Etkinliği
Primary Hypoparathyroidism, Current Treatment, and Recent Experience with Parathormone Analogs in Adults
Received Date : 09 Dec 2020
Accepted Date : 11 Feb 2021
Available Online : 17 Mar 2021
Doi: 10.25179/tjem.2020-80506 - Makale Dili: EN
Turk J Endocrinol Metab. 2021;25:216-226
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Parathormone (PTH) is a polypeptide hormone consisting of 84 amino acids. It is secreted from the parathyroid glands and functions to maintain serum calcium (Ca) and phosphate (PO4−) levels within a narrow range. Primary hypoparathyroidism (PHP) is a rare disease characterized by low PTH levels despite low serum Ca and high PO4 levels. It mostly occurs after thyroid surgery or due to autoimmunity. This review focuses primarily on hypoparathyroidism in adults, which is commonly treated with calcitriol and oral Ca. Since this treatment does not completely compensate for the physiological effects of the absent PTH, patients may still experience hypocalcemia-related symptoms. Moreover, PHP is associated with increased morbidity due to complications attributed to the disease itself and its treatment. PTH (1-34) and PTH (1-84), two analogs of PTH that have been used recently, provide better treatment outcomes. This review summarizes the etiology, current treatment modalities, and related complications, along with the recent experience of using PTH analogs.
ÖZET
Parathormon (PTH), 84 amino asitten oluşan polipeptid yapıda bir hormondur. Paratiroid bezlerinden salgılanarak serum kalsiyum (Ca) ve fosfat (PO4−) seviyelerini dar bir aralıkta tutulmasını sağlar. Primer hipoparatiroidizm (PHP), düşük serum Ca ve yüksek PO4 seviyelerine rağmen düşük PTH seviyeleri ile karakterize nadir bir hastalıktır. Çoğunlukla tiroid cerrahisi sonrası veya otoimmünite nedeniyle ortaya çıkar. Bu makalede esas olarak erişkinlerde saptanan primer hipoparatiroidizm üzerinde durulacaktır. Tedavide çoğunlukla kalsitriol ve oral kullanılmakta ancak PTH’nin fizyolojik etkilerini tamam olarak karşılanmadığından, hastalar hipokalsemi ile ilişkili semptomlar yaşayabilmektedirler. Ayrıca PHP, hastalığın kendisine ve tedavisi ile ilişkili komplikasyonlara bağlı olarak artan morbidite ile ilişkilidir. Son zamanlarda PHP tedavisine 2 PTH analoğu olan PTH (1-34) ve PTH (1-84) tedavisi kullanımı sunulmuştur. Bu derleme, etiyolojiyi, güncel tedavi yöntemlerini ve ilgili komplikasyonları, PTH analoglarının kullanımıyla ilgili son deneyimler özetlenecektir.
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