Diagnosis and management of hypoparathyroidism: recommendations of the working group of the Bone Section of the Hellenic Endocrine Society

Hypoparathyroidism (HypoPT) is a rare endocrine disorder characterized by hypocalcemia accompanied by low or inappropriately normal parathyroid hormone (PTH) levels. The Bone Section of the Hellenic Endocrine Society reviewed the available evidence and the recent international guidelines and provided updated clinical practice recommendations for the diagnosis and optimal management of patients with HypoPT. Specifically, permanent post-surgical HypoPT should be considered if the disorder persists for more than 12 months after surgery, while in non-surgical cases, appropriate genetic testing should be applied, especially in young patients or those with syndromic features. In addition, the current report provides recommended and suggested laboratory and imaging examinations for the optimal management of patients with HypoPT. Concerning management, the panel recommends conventional therapy with calcium and vitamin D analogs as first-line treatment, while in patients with inadequate disease control, PTH replacement therapy should be considered with close monitoring. Finally, the challenges of the diagnosis and management of HypoPT in pregnancy are also discussed.