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Results Introduction Aim Method Conclusions Evaluation of epidemiological features and dosage of the medication for permanent hypoparathyroidism patients while as a candidate of parathyroid transplantation H. Salepcioglu Kaya1, B. Goncu2, U. Karatoprak2, O. F. Duzenli2, E. Yucesan3, Y. E. Ersoy1, R. Kazancioglu4, A. Akcakaya1 1Bezmialem Vakıf University, Faculty of Medicine, Department of General Surgery, 2Bezmialem Vakıf University, Experimental Research Center, Parathyroid Transplantation Unit, 3Bezmialem Vakıf University, Faculty of Medicine, Department of Medical Biology, 4Bezmialem Vakıf University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology INTRODUCTION RESULTS Permanent hypoparathyroidism causes a significant The etiology of hypoparathyroidism was iatrogenic in 94% of the patients, autoimmune in 3%, idiopathic in 1%, decrease in quality of life. Symptoms such as fatigue and 304 patients who enrolled for parathyroid and congenital in 2% of patients. The mean intact parathyroid hormone (PTH) levels were 5.89pg/mL, 1.87pg/mL, at: cramping are seen in patients with permanent AGE REPARTITION BY transplantation were found eligible and 93 of GENDER 3.6pg/mL and 1.63pg/mL, in each etiological group, respectively (Figure 3). The mean calcium levels were hypoparathyroidism (1). These patients use daily calcium female male 8.44mg/dL, 8.54mg/dL, 8.25mg/dL and 7.83mg/dL, respectively in each etiological group (Table 1). The mean daily them were transplanted since, with an average Presented and active vitamin D preparations, but their quality of life calcium, cholecalciferol and, calcitriol intake depending on the age distribution were determined (Figure 2). shows a significant decrease (2). waiting time of 48 months. The average duration of hypoparathyroidism before enrolling on the Table 1: PTH and calcium levels by etiology of hypoparathyroidism. Field studies showed 25% of the patients were unable to transplantation list was found 118 months. Mean Value Iatrogenic Autoimmune Congenital work in any job and 54% of the patients had to switch to a 18 ETIOLOGY PTH (pg/mL) 5.89 1.87 3.6 1.63 simpler job. It was also noted that majority of the patients Calcium (mg/dL) 8.44 8.54 8.25 7.83 have social problems serious enough to use Currently, 211 patients are still waiting for 10 antidepressants (3). The outcome indicates that palliative parathyroid transplantation; among them 197 197 treatment is not sufficient to ease the symptoms of people (93%) are waiting for their first DRUG DOSES REPARTITION BY AGE 3500 1,8 hypoparathyroidism. transplantation, 14 people (7%) are waiting for 3 3000 1,58 1,6 their second transplant. In addition, six patients 1,4 National and international guidelines and, literature has no 68 2500 61 1,2 have a high PRA (min. MFI 2000 and max. MFI 1,12 defined criteria for the need for daily calcium and active 2000 1,07 1 vitamin D which is considered to be one of the most for HLA class I 18594 and for -class II 21790). 39 1500 3056 0,83 0,8 2600 0,72 128 patients (61%) are between 30 and 49 years 2160 2310 2324 0,6 important factors as part of palliative treatment (1, 3, 4). 1000 2009 1835 1917 1 1421 0,4 old. 178 of these patients (84.4%) are female and 500 1232 1 9 0,2 7 3 4 33 are male (15.6%). Particularly, 116 of 178 1 0 0 <20 <30 <40 <50 >49 iatrogenic autoimmune (65%) female patients are in their reproductive <20 <30 <40 <50 >49 Calcium Cholecalciferol Calcitriol idiopatic congenital AIM period (between 20 and 49 years old) (Figure 1). Figure 1: Age distribution of patients on the waiting list by gender. Figure 2: Daily calcium, calcitriol, and cholecalciferol intake of patients on the waiting list. Mean values Figure 3: Etiological distribution of patients on were presented and calcium intake listed in mg/day, cholecalciferol intake in IU/day and, calcitrol intake in the waiting list. Our aim is to assess parathyroid transplantation waiting µg/day. list by their epidemiological features and dosage of the medication, retrospectively. CONCLUSIONS REFERENCES ACKNOWLEDGEMENTS Permanent hypoparathyroidism has an elevated socioeconomic cost, affecting We would like to thank all our patients diagnosed with hypoparathyroidism and the relevant healthcare professionals METHOD particularly young people needing daily supplementations of calcium and 1 Underbjerg at al. Cardiovascular and renal complications to who works/worked in the General Surgery, Endocrinology, vitamin D, with the necessity of hospitalizations in 12.8% of the patients. postsurgical hypoparathyroidism: a Danish nationwide controlled To date, 304 of the patients who were diagnosed with historic follow-up study. J Bone Miner Res. 2013;28(11):2277-85. Nephrology and Organ Transplantation Units of Bezmialem Vakif University Hospital between December 2013 and hypoparathyroidism for iatrogenic or idiopathic or In our Unit, most of the patients were between 30 and 49 years old, regardless of 2 Yucesan et al. Fresh tissue parathyroid allotransplantation with short- December 2020. autoimmune causes have been registered on the waiting the etiology. These data show that hypoparathyroidism is a public health problem term immunosuppression: 1-year follow-up. Clin Transplant. 2017;31(11). list for transplantation. in this young population at their most productive ages, in socioeconomical terms. 3 Astor at al. Epidemiology and Health-Related Quality of Life in The patients who have enrolled on the waiting list of the Parathyroid transplantation is the most effective curative treatment option. We Hypoparathyroidism in Norway. J Clin Endocrinol Metab. CONTACT INFORMATION 2016;101(8):3045-53. Bezmialem Vakif University, Faculty of Medicine, suggest that a scoring system may be used for prioritizing patients on the waiting Composite tissue Harika Salepcioglu Kaya Correspondence: Harika Salepçioğlu Kaya MD. Department of General Surgery, Parathyroid list, estimated from variables including the etiology of hypoparathyroidism, 4 Yucesan at al. Importance of HLA typing, PRA and DSA tests for successful parathyroid allotransplantation. Immunobiology. Transplantation Unit between January 2013 and patients’ age, oral dose per medicine, frequency, and dosage of IV calcium Address: Adnan Menderes Bulvari, Vatan Caddesi, 34093, 2019;224(4):485-9. Fatih, Istanbul, Turkey December 2020 were evaluated etiologically, intake. socioeconomically and retrospectively. E-mail: [email protected] POS-008 ESOT2021.
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