Permanent hypoparathyroidism in different stages of the reproductive cycle

Abstract

Introduction: post-surgical hypoparathyroidism is the most common form of presentation of the disease and can present in a temporary or permanent way when it persists 6 months after the intervention.
Clinical case: 23-year-old woman with no history of hierarchy who underwent a total thyroidectomy for a papillary thyroid AC, suffered from permanent hypoparathyroidism, for which the dose of calcium and calcitriol was increased, but she remained hypocalcemic. For this reason, daily teriparatide was started, with normalization of serum calcium.
When her search for pregnancy began, teriparatide was discontinued and the dose of calcium and calcitriol increased; after conception she remained clinically and biochemically stable with the same dose of supplements throughout pregnancy, without complications. She was monitored during the 5 months of breastfeeding and it was seen that in the last month she became hypercalcemic.
Conclusion: teriparatide is a safe and effective option for patients with permanent hypoparathyroidism. Although it is contraindicated in pregnancy and lactation, it should generally not be a problem because in these circumstances, calcium increases naturally due to the action of PTHrP.