title: Hypoparathyroidism and autoimmunity in the 22q11.2 deletion syndrome.
abstract: OBJECTIVE
  To characterize the endocrine and autoimmune disturbances with emphasis on parathyroid dysfunction in patients with 22q11.2 deletion syndrome (22q11.2 DS). Design In this nationwide survey; 59 patients (age 1-54 years) out of 86 invited with a 22q11.2 DS were recruited through all the genetic institutes in Norway.
  
  
  METHODS
  Data was collected from blood tests, medical records, a physical examination and a semi-structured interview. We registered autoimmune diseases and measured autoantibodies, hormone levels and HLA types.
  
  
  RESULTS
  Twenty-eight (47%) patients had hypoparathyroidism or a history of neonatal or transient hypocalcemia. Fifteen patients had neonatal hypocalcemia. Fourteen patients had permanent hypoparathyroidism including seven (54%) of those above age 15 years. A history of neonatal hypocalcemia did not predict later occurring hypoparathyroidism. Parathyroid hormone levels were generally low indicating a low reserve capacity. Twenty-eight patients were positive for autoantibodies. Six (10%) persons had developed an autoimmune disease, and all were females (P<0.02). Hypoparathyroidism correlated with autoimmune diseases (P<0.05), however, no antibodies were detected against the parathyroid glands.
  
  
  CONCLUSIONS
  Hypoparathyroidism and autoimmunity occur frequently in the 22q11.2 DS. Neonatal hypocalcemia is not associated with later development of permanent hypoparathyroidism. Hypoparathyroidism may present at any age, also in adults, and warrants regular measurement of calcium levels. Hypoparathyroidism and autoimmunity occur frequently together. Our findings of autoimmune diseases in 10% of the patients highlight the importance of stringent screening and follow-up routines.
authors: Department of Endocrinology, Division of Medicine, Akershus University Hospital, N-1478 Lørenskog, Norway. kari.lima@medisin.uio.no
authors: Kari
authors: K
authors: Lima
authors: Tore G
authors: TG
authors: Abrahamsen
authors: Anette Bøe
authors: AB
authors: Wolff
authors: Eystein
authors: E
authors: Husebye
authors: Mohammad
authors: M
authors: Alimohammadi
authors: Olle
authors: O
authors: Kämpe
authors: Ivar
authors: I
authors: Følling