Hyperparathyroidism secondary to maternal hypoparathyroidism and vitamin D deficiency: an uncommon cause of neonatal respiratory distress

Demirel, Nihal; Aydın, Melahat; Zencıroğlu, Ayşegül; Okumuş, Nurullah; Çeti̇nkaya, Semra; Yildiz, Yasemin; Ipek, Mehmet Sah

doi:10.1179/146532809x440770

Cited by 30 publications

(30 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Skeletal deformities, fractures, parathyroid hyperplasia and clinical complications (e.g. respiratory distress, poor feeding and hypotonia) may result (27,29,30,31,32,33,34,35,36). Conversely, maternal overtreatment resulting in hypercalcaemia can suppress foetal parathyroid development causing neonatal hypocalcaemia.…”

Section: Pregnancy and Breastfeedingmentioning

confidence: 99%

European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults

Bollerslev¹,

Rejnmark²,

Marcocci³

et al. 2015

European Journal of Endocrinology

384

411

View full text Add to dashboard Cite

Hypoparathyroidism (HypoPT) is a rare (orphan) endocrine disease with low calcium and inappropriately low (insufficient) circulating parathyroid hormone levels, most often in adults secondary to thyroid surgery. Standard treatment is activated vitamin D analogues and calcium supplementation and not replacement of the lacking hormone, as in other hormonal deficiency states. The purpose of this guideline is to provide clinicians with guidance on the treatment and monitoring of chronic HypoPT in adults who do not have end-stage renal disease. We intend to draft a practical guideline, focusing on operationalized recommendations deemed to be useful in the daily management of patients. This guideline was developed and solely sponsored by The European Society of Endocrinology, supported by CBO (Dutch Institute for Health Care Improvement) and based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) principles as a methodological base. The clinical question on which the systematic literature search was based and for which available evidence was synthesized was: what is the best treatment for adult patients with chronic HypoPT? This systematic search found 1100 articles, which was reduced to 312 based on title and abstract. The working group assessed these for eligibility in more detail, and 32 full-text articles were assessed. For the final recommendations, other literature was also taken into account. Little evidence is available on how best to treat HypoPT. Data on quality of life and the risk of complications have just started to emerge, and clinical trials on how to optimize therapy are essentially non-existent. Most studies are of limited sample size, hampering firm conclusions. No studies are available relating target calcium levels with clinically relevant endpoints. Hence it is not possible to formulate recommendations based on strict evidence. This guideline is therefore mainly based on how patients are managed in clinical practice, as reported in small case series and based on the experiences of the authors. (2015) 173, G1-G20 European Journal of Endocrinology Summary of recommendationsThe recommendations are worded as recommend (strong recommendation) and suggest (weak recommendation). We formally graded only the evidence underlying recommendations for therapeutic choices and target calcium levels. The quality of evidence behind the recommendations is classified as very low (4BBB), low (44BB), moderate (444B) and strong (4444). See further section 'Summary of methods used for guideline development'. European Journal of EndocrinologyClinical Practice Guideline J Bollerslev, L Rejnmark and others ESE guideline on treatment of chronic HypoPT

show abstract

Section: Pregnancy and Breastfeedingmentioning

confidence: 99%

European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults

Bollerslev¹,

Rejnmark²,

Marcocci³

et al. 2015

European Journal of Endocrinology

384

411

View full text Add to dashboard Cite

show abstract

“…However, in specific cases, asymptomatic women have not been recognized until the newborn presented with severe secondary hyperparathyroidism, hypercalcemia, increased bone resorption, and fractures (242,912). If the mother remains hypocalcemic during pregnancy, maternal hypoparathyroidism can have a serious adverse impact on the fetus and neonate (492).…”

Section: Human Datamentioning

confidence: 99%

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Kovacs

2016

Physiological Reviews

383

524

View full text Add to dashboard Cite

During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ϳ30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.

show abstract

“…Typically, mothers of babies with congenital rickets have osteomalacia with severe vitamin D deficiency, low calcium intake, and hypocalcemia at delivery and had not taken vitamin D supplementation during pregnancy [83,[183][184][185][186][187][188][189][190][191][192][193][194][195][196][197] . In rare cases, congenital rickets can occur when mothers have had severe prolonged hypocalcemia not primarily caused by vitamin D deficiency such as poorly treated hypoparathyroidism [198][199][200][201] , renal failure [202][203][204][205][206] , received phosphate-containing enemas [207] , or iatrogenic hypermagnesemia [208] .…”

Section: Evidencementioning

confidence: 99%

Global Consensus Recommendations on Prevention and Management of Nutritional Rickets

Munns¹,

Shaw²,

Kiely³

et al. 2016

Horm Res Paediatr

362

477

View full text Add to dashboard Cite

Background: Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. Evidence: A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describes the strength of the recommendation and the quality of supporting evidence. Process: Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. Results: This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Conclusion: Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required. nology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. Results: This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Conclusion: Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required. Key WordsRickets · Nutrition · Vitamin D · Calcium · Consensus recommendations Abstract Background: Vitamin D and ca...

show abstract

Hyperparathyroidism secondary to maternal hypoparathyroidism and vitamin D deficiency: an uncommon cause of neonatal respiratory distress

Cited by 30 publications

References 10 publications

European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults

European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Global Consensus Recommendations on Prevention and Management of Nutritional Rickets

Contact Info

Product

Resources

About