Sonographic evaluation of subclinical entheseal involvement in patients with hypoparathyroidism: a case control study

• Published in: Journal of endocrinological investigation Vol. 46; no. 1; pp. 133 - 139
• Main Authors: Fırat, S. N., Kuşkonmaz, Ş. M., Önder, Ç. E., Omma, T., Genç, H., Çulha, C.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.01.2023; Springer Nature B.V
• Subjects: Calcium; Calcium (blood); Case-Control Studies; Correlation analysis; Endocrinology; Enthesopathy; Humans; Hypoparathyroidism; Hypoparathyroidism - diagnostic imaging; Hypoparathyroidism - etiology; Hypothyroidism; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Original Article; Parathyroid Hormone; Phosphorus; Statistical analysis; Ultrasonic imaging; Ultrasound; Vitamin D; Enthesopathy; Glasgow Ultrasound Enthesitis Scoring System; Hypoparathyroidism
• ISSN: 1720-8386; 0391-4097; 1720-8386
• DOI: 10.1007/s40618-022-01891-7

Purpose Hypoparathyroidism is a disease characterized by low serum calcium, increased serum phosphorus and low PTH levels. Although patients are treated with active vitamin D and calcium, a proper serum calcium phosphorus balance cannot always be achieved. Ectopic calcifications that develop in organs during treatment are the most common complications. To date, there is not any published study on enthesopathy in patients with hypoparathyroidism. The aim of this study was to evaluate subclinical enthesopathy in patients with hypoparathyroidism with ultrasound and to compare the results with those of the control group. Methods The study included patients aged 18–65 years with postoperative hypoparathyroidism and hypothyroidism (group hypoP + hypoT), patients with postoperative hypothyroidism (group hypoT), and healthy age and sex-matched volunteers (group C). Ultrasonographic findings of enthesopathy in both extremities were documented according to the Glasgow Ultrasound Enthesitis Scoring System (GUESS). Results GUESS scores in group hypoP + hypoT, were significantly higher when compared to the other groups. There was a statistically significant correlation between the total GUESS scores and total enthesophyte scores and the duration of hypoparathyroidism ( p  < 0.05, r  = 0.43) ( p  < 0.05, r  = 0.39) respectively. In the correlation analysis of all groups, a significant negative correlation was found between serum Ca and PTH levels and the total GUESS scores ( p  < 0.01, r  = − 0.37; p  < 0.01, r  = − 0.54, respectively). Conclusion This study showed that GUESS scores were significantly higher in patients with hypoparathyroidism compared to those with hypothyroidism and control subjects. GUESS scores were positively correlated with disease duration. Patients with hypoparathyroidism need to be evaluated for subclinical enthesopathy during follow-up.