Hypoparathyroidism and Hypocalcemic States

Chapter

Abstract

A Caucasian 35-year-old woman at the 7th month of pregnancy was hospitalized for a spontaneous right hip fracture. She was suffering from asthenia, cramps, sometimes hypotension and tachycardia. She was 165 cm height and 60 kg weight. She referred a history of type I diabetes diagnosed when she was 20 years old and a Hashimoto’s thyroiditis with hypothyroidism diagnosed when she was 30 years old. She performed a therapy with insulin and Levo-thyroxine (l-thyroxine 125 mcg/day). In addition, vitiligo was started before adulthood.

Keywords

Hypocalcemia—acute, chronic Differential diagnosis Treatment Sterol therapy Refractoriness Hypoparathyroidism 

References

  1. 1.
    Leibrandt T, editor. Diagnostics. Nurse’s Reference Library, Nursing Books; 1983; pp. 1–1089.Google Scholar
  2. 2.
    Shoback D. Hypoparathyroidism. N Engl J Med. 2008;359:391–403.PubMedCrossRefGoogle Scholar
  3. 3.
    Broadus AE. Mineral balance and homeostasis. In: Favus MJ, editor. Primer on the metabolic bone diseases and disorders of mineral metabolism. 5th ed. Washington DC: American Society for Bone and Mineral Research; 2003. p. 105–11.Google Scholar
  4. 4.
    Bushinsky DA, Monk RD. Electrolyte quintet: calcium. Lancet. 1998;352:306–11.PubMedCrossRefGoogle Scholar
  5. 5.
    Maeda SS, Fortes EM, Oliveira MU, Borba VCZ, Lazaretti-Castro M. Hypoparathyroidism and pseudohypoparathyroidism. Arq Bras Endocrinol Metab. 2006;50–4:664–73.CrossRefGoogle Scholar
  6. 6.
    Rubin MR, Dempster DW, Zhou H, Shane E, Nickolas T, Sliney Jr J, Silverberg SJ, Bilezikian JP. Dynamic and structural properties of the skeleton in hypoparathyroidism. J Bone Miner Res. 2008;23:2018–24.PubMedCrossRefGoogle Scholar
  7. 7.
    Shoback D. Hypocalcemia: definition, etiology, pathogenesis, diagnosis and management. In: Rosen CJ, Compston JE, Lian JB, editors. Primer on the metabolic bone diseases and disorders of mineral metabolism, chapter 68. 7th ed. Washington DC: ASBMR; 2008. p. 313–7.CrossRefGoogle Scholar
  8. 8.
    Masi L, Winer KK, Potts JP, Brandi ML. Management of hypoparathyroidism. Clin Cases Miner Bone Metab. 2004;2:127–8.Google Scholar
  9. 9.
    Litvak J, Moldawer MP, Forbes AP, Henneman PH. Hypocalcemic hypercalciuria during vitamin D and dihydrotachysterol therapy of hypoparathyroidism. J Clin Endocrinol Metab. 1958;18:246–71.PubMedCrossRefGoogle Scholar
  10. 10.
    Weber G, Cazzuffi MA, Frisone F, et al. Nephrocalcinosis in children and adolescents: sonographic evaluation during long-term treatment with 1,25-dihydrocholecalciferol. Child Nephrol Urol. 1988;89:273, 2762–2763.Google Scholar
  11. 11.
    Bouillon R, Okamura WH, Norman AW. Structure-function relationship in the vitamin D endocrine system. Endocr Rev. 1995;36:200–57.Google Scholar
  12. 12.
    Levine M. Hypoparathyroidism and pseudohypoparathyroidism. In: DeGroot LJ, Jameson JL, editors. Endocrinology. 4th ed. Philadelphia: WB Saunders; 2001. p. 1133–53.Google Scholar
  13. 13.
    Sato K, Hasegawa Y, Nake J, Nanao K, Takahashi I, Tajima T, Shinohara N, Fujieda K. Hyrochlorothiazide effectively reduces urinary calcium excretion in two Japanese patients with gain-of-function mutations of the calcium-sensing receptor gene. J Clin Endocrinol Metab. 2002;87:3068–73.PubMedCrossRefGoogle Scholar
  14. 14.
    Lienhardt A, Bai M, Lagarde JP, Rigaud M, Zhang Z, Jiang Y, Kottler ML, Brown EM, Garabedian M. Activating mutations of the calcium-sensing receptor: management of hypocalcemia. J Clin Endocrinol Metab. 2001;86:5313–23.PubMedCrossRefGoogle Scholar
  15. 15.
    Winer KK, Ko CW, Reynolds JC, Dowdy K, Keil M, Peterson D, et al. Long-term treatment of hypoparathyroidism: a randomized controlled study comparing parathyroid hormone-(1–34) versus calcitriol and calcium. J Clin Endocrinol Metab. 2003;88:4214–20.PubMedCrossRefGoogle Scholar
  16. 16.
    Van Den Driessche A, Eenkoorn V, Van Gall L, De Block C. Type 1 diabetes and autoimmune polyglandular syndrome: a clinical review. Neth J Med. 2009;67:376–87.PubMedGoogle Scholar
  17. 17.
    Kovacs CS, Kronenberg HM. Pregnancy and lactation. In: Rosen CJ, editor. Primer on the metabolic bone diseases and disorders of mineral metabolism, chapter 18. 7th ed. Washington DC: ASBMR; 2008. p. 90–5.CrossRefGoogle Scholar
  18. 18.
    Bilezikian J, Khan A, Potts J, Brandi ML, Clarke B, Shoback D, et al. Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology target-organ involvement, treatment and challenges for future research. JBMR. 2011;26:2317–37.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of MedicineUniversity of Florence, Centro di Riferimento Regionale sui Tumori Endocrini Ereditari, Azienda Ospedaliero-Universitaria CareggiFlorenceItaly

Personalised recommendations