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  • 252.1 Hypoparathyroidism
  • Associated ICD-9-CM PT diagnoses/treatment diagnoses that may be directly related
    • 315.4 Developmental coordination disorder
    • 718.45 Contracture of joint, pelvic region, and thigh
    • 719.70 Difficulty in walking involving joint site unspecified
    • 728.2 Muscular wasting and disuse atrophy not elsewhere classified
    • 728.89 Other disorders of muscle, ligament, and fascia
    • 729.9 Other and unspecified disorders of soft tissue
    • 780.7 Malaise and fatigue
    • 781.2 Abnormality of gait
    • 782.3 Edema
    • 786.0 Dyspnea and respiratory abnormalities
    • 786.05 Shortness of breath

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  • E20.0 Idiopathic hypoparathyroidism
  • E20.1 Pseudohypoparathyroidism
  • E20.8 Other hypoparathyroidism
  • E20.9 Hypoparathyroidism, unspecified
  • E89.2 Post-procedural hypoparathyroidism
  • P71.4 Transitory neonatal hypoparathyroidism

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Description

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  • Insufficient hyperparathyroid hormone from four parathyroid glands resulting in low calcium and high phosphorus
  • Muscle cramps
  • Low calcium

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Essentials of Diagnosis

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  • Muscle spasms as severe as tetany
  • Abdominal cramps
  • Low calcium
  • High phosphorus levels
  • Decreased calcium in urine
  • Positive Chvostek sign
  • Positive Trousseau phenomenon

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General Considerations

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  • Can be congenital or acquired2
  • Can have autoimmune bias2
  • Diagnosis for more occult problems may take time and require intensive medical diagnostic testing
  • May cause pathology in multiple organ systems
    • GI: liver
    • Cardiovascular: heart, peripheral circulation, blood pressure
    • Integumentary
  • May result in secondary problems indicating the need for PT intervention depending on severity
    • Aerobic capacity and muscle endurance impairment
    • Sarcopenia
    • Weakness/impaired muscle performance
    • Musculoskeletal problems
    • Neuromuscular problems

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Demographics

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  • Considered rare
  • Lifespan

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Signs and Symptoms

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  • Signs and symptoms of hypocalcemia2
  • Hyperphosphatemia2
  • Peripheral paresthesias
  • Paresthesias in lips
  • Muscle aches/pain
  • Muscle cramps in lower extremities (LEs), abdomen, or face
  • Twitching or spasms in muscles and throat
  • Fatigue
  • Weakness
  • Painful menstruation
  • Patchy hair loss (e.g., eyebrows)
  • Dry, coarse, scaly skin
  • Brittle nails
  • Anxiety
  • Nervousness
  • Headaches
  • Depression, mood swings
  • Memory problems
  • Loss of consciousness/fainting
  • Seizures
  • Malformations of teeth
  • Kidney disease
  • Arrhythmias
  • Heart failure
  • Vision impairment; cataracts
  • Short stature
  • Slow mental development in children
  • Calcium deposits in the brain
  • Abdominal pain
  • Breathing difficulties secondary to throat spasms
  • Painful menstruation

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Functional Implications

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  • Inability or reluctance to leave home secondary to not feeling well or impaired mental status
  • Fatigue
  • Inability to focus
  • Kidney disease
  • Shortness of breath
  • Muscle performance deficits, inability to ambulate or perform self-care, and aerobic capacity limitation secondary to inactivity
  • Decreased exercise tolerance
  • Sleep disturbances
  • Changes in lifestyle
  • Inappropriate self-medication
  • Anxiety and irritability
  • Limitations in ADLs or IADLs
  • Neuropathy, increased risk for falls
  • Low mentation, need for special schooling considerations

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Possible Contributing Causes

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  • Inability to afford testing and medications and noncompliance with medication regiments/inability to pay
  • Damage/trauma to the parathyroid glands
  • Heredity
  • ...

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