{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T17:23:58Z","timestamp":1783445038468,"version":"3.54.6"},"reference-count":10,"publisher":"Bioscientifica","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":2238,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Standard treatment of hypoparathyroidism consists of supplementation of calcium and vitamin D analogues, which does not fully restore calcium homeostasis. In some patients, hypoparathyroidism is refractory to standard treatment with persistent low serum calcium levels and associated clinical complications. Here, we report on three patients (58-year-old male, 52-year-old female, and 48-year-old female) suffering from severe treatment-refractory postsurgical hypoparathyroidism. Two patients had persistent hypocalcemia despite oral treatment with up to 4 \u00b5g calcitriol and up to 4 g calcium per day necessitating additional i.v. administration of calcium gluconate 2\u20133 times per week, whereas the third patient presented with high frequencies of hypocalcemic and treatment-associated hypercalcemic episodes. S.c. administration of rhPTH (1\u201334) twice daily (40 \u00b5g\/day) or rhPTH (1\u201384) (100 \u00b5g\/day) only temporarily increased serum calcium levels but did not lead to long-term stabilization. In all three cases, treatment with rhPTH (1\u201334) as continuous s.c. infusion via insulin pump was initiated. Normalization of serum calcium and serum phosphate levels was observed within 1 week at daily 1\u201334 parathyroid hormone doses of 15 \u00b5g to 29.4 \u00b5g. Oral vitamin D and calcium treatment could be stopped or reduced and regular i.v. calcium administration was no more necessary. Ongoing efficacy of this treatment has been documented for up to 7 years so far. Therefore, we conclude that hypoparathyroidism that is refractory to both conventional treatment and s.c. parathyroid hormone (single or twice daily) may be successfully treated with continuous parathyroid hormone administration via insulin pump.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points:<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1530\/edm-20-0009","type":"journal-article","created":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T03:15:42Z","timestamp":1590981342000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":5,"title":["Continuous rhPTH (1\u201334) treatment in chronic hypoparathyroidism"],"prefix":"10.1530","volume":"2020","author":[{"given":"Carmina Teresa","family":"Fuss","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Diabetology 1","department":["Department of Medicine I, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Burger-Stritt","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology 1","department":["Department of Medicine I, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Horn","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology 1","department":["Department of Medicine I, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Cathrin","family":"Koschker","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology 1","department":["Department of Medicine I, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Frey","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology 1","department":["Department of Medicine I, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almuth","family":"Meyer","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology 2","department":["Department of Internal Medicine, Helios Klinikum Erfurt, Erfurt, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Hahner","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology 1","department":["Department of Medicine I, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2020,5,29]]},"reference":[{"key":"2026070712180356100_bib1","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1002\/jbmr.483","article-title":"Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research","volume":"26","author":"Bilezikian","year":"2011","journal-title":"Journal of Bone and Mineral Research"},{"key":"2026070712180356100_bib2","doi-asserted-by":"crossref","first-page":"2300","DOI":"10.1210\/jc.2015-3909","article-title":"Presentation of hypoparathyroidism: etiologies and clinical features","volume":"101","author":"Shoback","year":"2016","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"2026070712180356100_bib3","first-page":"275","article-title":"Efficacy and safety of recombinant human parathyroid hormone (1\u201384) in 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