Tratamiento del hipoparatiroidismo con hormona paratiroidea

  • Esteban Cardona Universidad de Antioquia
  • Carlos Alfonso Builes-Barrera Universidad de Antioquia
  • Alejandro Román-González Universidad de Antioquia

Resumen

El hipoparatiroidismo es un trastorno del metabolismo del calcio infrecuente. La principal etiología es la posquirúrgica en el 75% de los casos. El hipoparatiroidismo crónico tiene una prevalencia estimada de 20-40 por cada 100.000 habitantes. Las manifestaciones clínicas varían desde cuadros asintomáticos hasta neuromusculares, neurológicas, cognitivas, cardiacas y disminución en la calidad de vida. El tratamiento estándar es la suplementación de calcio y calcitriol. Es frecuente la refractariedad a este enfoque terapéutico y se asocia a una alta incidencia de efectos adversos por las altas dosis de suplementos requeridas. Hasta hace poco era la única deficiencia endocrina no tratada con terapia de sustitución hormonal. Recientemente, la FDA ha aprobado el uso de la PTH recombinante (1-84) para el tratamiento del hipoparatiroidismo refractario. Hay dos análogos de PTH disponibles (PTH 1-84 y PTH 1-34). Ambas moléculas se han asociado a una disminución en los requerimientos de suplementación con calcio y calcitriol, manteniendo concentraciones estables de calcio sérico y fosfato, mejor calidad de vida y un metabolismo óseo más fisiológico con una baja incidencia de efectos adversos. Actualmente, la terapia de sustitución hormonal con PTH no hace parte del tratamiento de rutina del hipoparatiroidismo y tiene unas indicaciones estrictas.

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Biografía del autor

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Estudiante de Medicina, Universidad de Antioquia, Medellín, Colombia

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Profesor, Departamento de Medicina Interna, Universidad de Antioquia. Internista Endocrinólogo, Hospital Universitario San Vicente Fundación, Medellín, Colombia

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Profesor, Departamento de Medicina Interna, Universidad de Antioquia. Internista Endocrinólogo, Hospital Universitario San Vicente Fundación, Medellín, Colombia

Citas

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Publicado
2019-03-21
##submission.howToCite##
CARDONA, Esteban; BUILES-BARRERA, Carlos Alfonso; ROMÁN-GONZÁLEZ, Alejandro. Tratamiento del hipoparatiroidismo con hormona paratiroidea. Revista Colombiana de Endocrinología, Diabetes & Metabolismo, [S.l.], v. 6, n. 1, p. 35-41, mar. 2019. ISSN 2389-9786. Disponible en: <http://revistaendocrino.org/index.php/rcedm/article/view/466>. Fecha de acceso: 24 jun. 2019
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