Poster Abstract Abstract

(Adults - Parathyroid/Bone & Calcium Metabolism), #220531221694

An audit of the management of patients with hypoparathyroidism in Hospital Putrajaya

Ng Yoke Mui, Hospital Putrajaya; Muhammad Asyraf bin Abdul Onny, Hospital Putrajaya; Zanariah Hussein, Hospital Putrajaya

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Introduction

Hypoparathyroidism is a rare endocrine disorder characterized by hypocalcaemia associated with an inappropriately low parathyroid hormone concentration. As currently there is no Malaysian guideline for the management of this condition, we performed an audit comparing our performance with published European guidelines.

Methods

The notes of 36 patients aged 21–76 years with hypoparathyroidism for at least 1 year who were managed in Internal Medicine and Endocrine Clinic, Hospital Putrajaya, were reviewed. Data was obtained from the computerized clinical notes database and the pathology system.

Results

The most common etiology was previous thyroidectomy (86.1%). Serum calcium and phosphate were measured at least annually in almost all patients (94.4%). Serum creatinine was checked at least annually in 94.4%. Serum vitamin D was measured in 61.1%. 24 h urine calcium excretion was only checked in 25.0%. The target for calcium and phosphate was stated in only 2.8%. In no patient was the calcium phosphate product recorded. Ultrasound kidney was done in 22.2% and cataract screening performed in 5.6%.

Almost half of them (44.4%) were admitted for symptomatic hypocalcemia. 16.7% developed renal impairment.

Most patients (91.7%) were prescribed with calcium carbonate. 61.1% were on alfacalcidol. None was on adjunctive treatment.

Conclusion

It is evident that locally, the long-term outpatient monitoring and recording of hypoparathyroidism is inadequate. We are therefore constructing a checklist of relevant variables to standardize management and facilitate further audit.

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