Teriparatide Therapy in a 4-Month-Old With Severe Hypoparathyroidism

Area of Science:

• Pediatric Endocrinology
• Pharmacology

Background:

• Teriparatide, a parathyroid hormone analog, is FDA-approved for osteoporosis in adults.
• Limited data exists on teriparatide's long-term efficacy and safety in pediatric hypocalcemia and hypoparathyroidism.

Purpose of the Study:

• To describe the use of teriparatide in a premature infant with severe hypoparathyroidism.
• To evaluate the impact of teriparatide on calcium and phosphorus levels and supplementation requirements.

Main Methods:

• A 4-month-old premature infant (32 weeks gestational age) with severe hypoparathyroidism received subcutaneous teriparatide injections.
• Serum ionized calcium and phosphorus levels were monitored over a 6-month period.
• Supplementation requirements for calcitriol, vitamin D, and calcium carbonate were assessed.

Main Results:

• Teriparatide treatment led to a substantial decrease in the infant's need for calcitriol, vitamin D, and calcium carbonate.
• Serum ionized calcium concentrations increased, and serum phosphorus concentrations decreased during the 6-month study period.
• Teriparatide was well tolerated, with no observed hypercalcemia.

Conclusions:

• Teriparatide may be an effective treatment option for severe hypoparathyroidism in infants.
• This case suggests teriparatide can reduce the burden of oral supplementation in pediatric hypocalcemia.
• Further research is warranted to establish long-term safety and efficacy in the pediatric population.