Table 1.

Evaluation of Hypoparathyroidism

Family history

Parathyroid disease

Other endocrine disease

Autoimmune disorders

Personal history

Prior anterior neck surgery for parathyroid or thyroid disease.

Other endocrine disease.

Kidney stones or fractures

Dietary and supplemental intake of calcium, vitamin D

Physical examination

Chvostek or Trousseau sign

Eyes: cataracts

Neck: signs of previous surgery

Skin: mucocutaneous candidiasis, other fungal infection, vitiligo

Joints: arthritis

Biochemical evaluation

Biochemical screen with total calcium, albumin, blood urea nitrogen, and creatinine

Parathyroid hormone

Ionized calcium (see text)

25-hydroxy- and 1,25-dihydroxyvitamin D

Estimated glomerular filtration rate

24-hour urine for creatinine, calcium, and biochemical stone risk profile

Target organ imaging

Bone mineral density

Abdomen: ultrasound or computed tomography

Skull (optional)

Genetic: only if family or personal history of other information leads to this possibility