title: Prevalence of clinical remission in patients with sporadic idiopathic hypoparathyroidism.
abstract: BACKGROUND
  Remission of disease activity is a characteristic feature of autoimmune endocrine disorders such as Graves' disease, Addison's disease and occasionally in patients with premature ovarian failure. Autoimmunity is also implicated in sporadic idiopathic hypoparathyroidism (SIH) with clinical remission of disease reported in three cases.
  
  
  OBJECTIVE
  To assess the rate of remission in patients with sporadic idiopathic hypoparathyroidism and review the cases reported so far.
  
  
  METHODS
  Subjects included 53 patients (M:F, 24:29) with SIH who had been symptomatic for at least 1 year (range 1-31 years). They were treated with calcium and 1-alpha-(OH)D(3)/cholecalciferol therapy and had a mean duration of follow up of 5.0 +/- 3.2 years. Treatment was withdrawn in two stages in the patients who maintained normal levels of serum total calcium during the preceding year of treatment. In stage-1, the dose of therapy was reduced to half and subsequently all treatment was stopped (stage 2) in those patients who maintained normal serum total calcium levels on the reduced dose. Remission of SIH was defined as maintenance of normal serum total (>or=2.12 mmol/l) and ionized calcium, inorganic phosphorus and serum intact parathyroid hormone (iPTH) for at least 3 months after withdrawal of calcium and 1-alpha-(OH)D(3)/cholecalciferol therapy. Calcium sensing receptor autoantibodies (CaSRAb) were determined by Western blot.
  
  
  RESULTS
  Two of the 53 patients (3.8%) with SIH stayed in remission for 1 year after complete withdrawal of therapy. CaSRAb was absent in both the cases. The clinical features, age at onset and duration of hypocalcaemic symptoms in cases with remission were comparable to those who did no show remission.
  
  
  CONCLUSIONS
  Sporadic idiopathic hypoparathyroidism is not irreversible as is widely believed and spontaneous remission of disease may occur in 3.8% of patients.
authors: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India. gosravinder@hotmail.com
authors: Ravinder
authors: R
authors: Goswami
authors: Siya
authors: S
authors: Goel
authors: Neeraj
authors: N
authors: Tomar
authors: Nandita
authors: N
authors: Gupta
authors: Vanshika
authors: V
authors: Lumb
authors: Yagya Dutta
authors: YD
authors: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D002118:Calcium / Q000008:administration & dosage; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006887:Hydroxycholecalciferols / Q000008:administration & dosage; D007011:Hypoparathyroidism / Q000188:drug therapy / Q000453:epidemiology*; D007194:India / Q000453:epidemiology; D008297:Male; D018579:Patient Selection; D012075:Remission, Spontaneous; D014815:Vitamins / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D006887:Hydroxycholecalciferols; D014815:Vitamins; D002118:Calcium