Initiation of Continuous rhPTH Infusion With Insulin Pump in an Inpatient Setting.
Faith LindsayKaren K WinerKarla JohnsonHalley WassermanPublished in: JCEM case reports (2023)
Hypoparathyroidism is one of the few remaining hormonal insufficiencies not treated with replacement of its missing hormone. Conventional therapy involves multiple daily oral doses of calcium, active vitamin D, and magnesium, which is not only cumbersome for patients, but carries risk of nephrocalcinosis and is inadequate in patients with enteral malabsorption. Subcutaneous parathyroid hormone 1-34 (PTH[1-34]) has been tested as a hormonal replacement therapy for treatment of hypoparathyroidism. PTH(1-34) delivered by continuous infusion via insulin pump decreases or eliminates the need for oral medications, stabilizes serum and urine calcium at normal levels with minimal fluctuation, and significantly reduces PTH doses. In this case report, we describe the clinical application of PTH(1-34) via insulin pump in an adolescent with autoimmune polyendocrinopathy syndrome type 1 (APS1). Transition to a PTH pump reduced hospital admissions for calcium abnormalities and allowed our patient to discontinue all scheduled daily conventional therapy.
Keyphrases
- case report
- type diabetes
- end stage renal disease
- glycemic control
- newly diagnosed
- mental health
- physical activity
- ejection fraction
- low dose
- chronic kidney disease
- young adults
- palliative care
- polycystic ovary syndrome
- peritoneal dialysis
- skeletal muscle
- insulin resistance
- mesenchymal stem cells
- adipose tissue
- bone marrow
- drug induced
- cell therapy