Quantification of Symptom Load by a Disease‐Specific Questionnaire HPQ 28 and Analysis of Associated Biochemical Parameters in Patients With Postsurgical Hypoparathyroidism

Abstract

In hypoparathyroidism (HypoPT), patients suffer severely from reduced quality of life. The complexity of HypoPT demands a disease‐specific control instrument to characterize symptom load. We employed a newly developed disease‐specific Hypoparathyroid Patient Questionnaire (the HPQ 40/28) to investigate and quantify HypoPT patients' complaints and contributing factors. In this cross‐sectional, two‐center study, patients with postsurgical HypoPT (n = 49) were matched for gender and age and compared with patients having undergone thyroid surgery without HypoPT (n = 39) and patients with primary hyperparathyroidism (n = 35). The HPQ 40/28 was completed when patients visited the respective center. Clinical background information, blood tests, and current medication were documented by the physician. Serum calcium lay within the reference range in 87% of HypoPT patients, serum phosphate in 95.7%, and calcium–phosphate product (CPP) in 100%. HPQ 40/28 scores for the scales “pain and cramps” (PaC), “neurovegetative symptoms” (NVS), “numbness or tingling,” and “heart palpitations” were significantly elevated in comparison with control groups. Correlations between complaints and laboratory parameters could be demonstrated in the HypoPT group, with serum calcium correlating with NVS (r = 0.309, p < 0.05) and serum phosphate with loss of vitality (r = 0.349, p < 0.05). CPP was the main contributor to symptom load with an influence on PaC (r = 0.295, p < 0.05), loss of vitality (r = 0.498, p < 0.001), numbness or tingling (r = 0.328, p < 0.05), and memory problems (r = 0.296, p < 0.05). In conclusion, the newly developed HPQ 40/28 successfully identified and quantified symptoms typical in HypoPT patients. Using the HPQ 40/28, the CPP was identified as the predominant factor in the severity of complaints in HypoPT. © 2020 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.