To the best of our knowledge, this is the first case in Turkey in whom teriparatide was administered for classical treatment-resistant hypoparathyroidism using an insulin pump and succeeded in achieving normocalcemia.
Primary outcome measures related to treatment efficacy included: a) need for another specific drug treatment; b) elapsed time to achieve normocalcemia (8.5-10.5 mg/dL); and c) recurrence of hypercalcemia (elevation of calcium levels above >10.5 mg/dL after achievement of normocalcemia).
One of the common nutritional deficiencies among these groups of patients is secondary normocalcemic hyperparathyroidism (SNHPT) [1, 2, 4-7, 20, 21], characterized by low serum 25-hydroxy vitamin D levels, high PTH levels, and normocalcemia .
(1) Laboratory abnormalities are those seen with secondary/tertiary hyperparathyroidism and include elevated parathyroid hormone, elevated alkaline phosphatase (indicating bone turnover), hypo- or normocalcemia, hyperphosphatemia, and decreased 1,25 dihydroxyvitamin D.
(22) to be able to make a diagnosis of multiple parathyroid adenoma, I) in the operation, there must be more than 1 and fewer than 4 involvements of the parathyroid gland, II) at least 1 of the parathyroid glands must be normal, III) there must not be multiple endocrine neoplasia or familial hyperparathyroidism, and IV) postoperatively permanent normocalcemia must be able to be obtained in the patient.