Cases reported "hypoparathyroidism"

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1/382. Unaccountable severe hypercalcemia in a patient treated for hypoparathyroidism with dihydrotachysterol.

    This report describes a forty-seven-year-old female patient with a complex medical history. She was suffering from an unspecified interstitial lung disease, papillary thyroid carcinoma which had been treated, hypoparathyroidism after thyroidectomy for which she was receiving dihydrotachysterol and calcium, and atrial fibrillation and congestive heart failure as a result of mitral stenosis. Shortly after mitral valve replacement she developed a severe hypercalcemia (serum calcium 5.95 mmol/l) during a febrile illness. At that time anti-tuberculous agents were also being administered for presumed tuberculosis. The possible mechanisms for this severe elevation of the calcium level are discussed. immobilization, while Paget's bone disease was present, and perhaps enhanced activation of dihydrotachysterol by rifampicin, could have led to increased calcium-release into the circulation. Continuous supplecation of calcium and vitamin d, provoked dehydration and the mechanism of the milk-alkali syndrome also contributed to this extremely high calcium level. It is concluded that hypoparathyroid patients being treated with vitamin d and calcium should be carefully monitored in the case of an intercurrent illness or a change in medication. ( info)

2/382. Kenny-Caffey syndrome: an Arab variant?

    We describe 2 unrelated Bedouin girls who met the criteria for the diagnosis of Kenny-Caffey syndrome. The girls had some unusual features--microcephaly and psychomotor retardation--that distinguish the Kenny-Caffey syndrome profile in Arab children from the classical Kenny-Caffey syndrome phenotype characterized by macrocephaly and normal intelligence. The 2 girls did not harbor the 22q11 microdeletion (the hallmark of the DiGeorge cluster of diseases) that we previously reported in another Bedouin family with the Kenny-Caffey syndrome (Sabry et al. J Med Genet 1998: 35(1): 31-36). This indicates considerable genetic heterogeneity for this syndrome. We also review previously reported 44 Arab/Bedouin patients with the same profile of hypoparathyroidism, short stature, seizures, mental retardation and microcephaly. Our results suggest that these patients represent an Arab variant of Kenny-Caffey syndrome with characteristic microcephaly and psychomotor retardation. We suggest that all patients with Kenny-Caffey syndrome should be investigated for the 22q11 microdeletion. Other possible genetic causes for the Kenny-Caffey syndrome or its Arab variant include chromosome 10p abnormalities. ( info)

3/382. Coexistence of primary endocrine deficiencies: a unique case of male hypergonadism associated with hypoparathyroidism, hypoadrenocorticism, and hypothyroidism.

    The unique combination of male hypogonadism with hypoparathyroidism, hypoadrenalism, hypothyroidism, diabetes mellitus, and alopecia totalis has been documented in a male patient who has been followed over the past 28 years. In this patient, first seen at the age of six for hypoparathyroidism alone, repeated clinical and laboratory endocrine evaluation detected the sequential development of the additional endocrine deficiencies. The presence of abnormal serum antibodies is consistent with an atuoimmune pathogenesis of this syndrome. ( info)

4/382. Bilateral femoral neck fractures secondary to hypocalcemic seizures in a skeletally immature patient.

    We report the case of an 11-year-old, skeletally immature boy who sustained bilateral femoral neck fractures during seizure activity. These fractures were due to hypocalcemia. Although this condition is a rare complication of seizures, its early recognition and treatment are essential to minimize complications associated with the delayed treatment of intracapsular hip fractures. ( info)

5/382. Primary hypomagnesemia caused by isolated magnesium malabsorption: atypical case in adult.

    Isolated magnesium malabsorption is a rare disorder, which bas been described in no more than 30 patients worldwide. patients with this disorder typically present with convulsion and diarrhea in early infancy. Hypomagnesemia and hypocalcemia were found in a 35-year-old man with muscle cramps, who bad been diagnosed as primary hypoparathyroidism. Oral magnesium therapy corrected the low serum calcium, magnesium and parathyroid hormone levels. We report an atypical case of isolated magnesium malabsorption in an adult. ( info)

6/382. New technique of parathyroidectomy to prevent parathyromatosis and hypoparathyroidism.

    A 54-year-old woman with end-stage renal disease and on haemodialysis for 4 years developed severe secondary hyperparathyroidism and was operated upon. The two upper and the largest lower parathyroid glands were resected. The right lower gland was dissected from the lower pole of the thyroid and, by gently pulling upwards, the lateral walls were dissected using electrocautery. The lower aspect of the gland maintained the blood supply through small mediastinal and thymic vessels of the neopedicle, which allowed its mobilization to a more superficial plane. Because of the large size of the gland, the part opposite to the neopedicle was resected and the cutting surface was sealed with fibrin adhesive. Pre-thyroidal muscles were reapproximated and the remnant of the parathyroid gland was pulled out through a small hole in the inferior part of the midline and sutured with fine silk to the muscle. The gland was therefore placed in a subcutaneous position in the lowest part of the operative field just above the sternal border. The postoperative course was uneventful and, 8 months after surgery, the patient maintains a normal parathyroid function. ( info)

7/382. A rapidly progressive cataract in a patient with autoimmune hypoparathyroidism and acute liver and renal failure.

    cataract is a well-known complication of hypoparathyroidism, albeit the mechanism is obscure. The progression of cataract is typically slow in patients with idiopathic hypoparathyroidism. We describe a case of an extremely rapid evolution of typical hypocalcemic cataracts in a patient with familial autoimmune hypoparathyroidism during acute idiopathic hepatic and renal failure, while serum calcium and phosphorus were unbalanced. physicians and ophthalmologists must be aware of cataracts developing rapidly in the setting of such metabolic derangements. ( info)

8/382. Idiopathic hypoparathyroidism associated with adult rheumatoid arthritis.

    A 48-year-old female patient with adult onset idiopathic hypoparathyroidism diagnosed at the age of 28 years developed a typical seropositive rheumatoid arthritis (RA) at 46 years of age after several years of evolution of a palindromic rheumatism. Only one case of an association between idiopathic hypoparathyroidism and RA has been described in the medical literature. autoimmunity seems to play a pivotal role in the aetiopathogenesis of both diseases, and could explain the nature of this association; nevertheless, a chance association could not be excluded. ( info)

9/382. hypoparathyroidism, intracranial calcification, and seizures 61 years after thyroid surgery.

    Though hypocalcemic symptoms from hypoparathyroidism following thyroidectomy most often occur in the immediate postoperative period, hypoparathyroidism can present itself many years after the thyroid surgery with nonspecific symptoms. We present herein the case of a 74-year-old woman with previously undiagnosed hypoparathyroidism who had tonic-clonic seizures and intracranial calcification 61 years after her thyroidectomy. This case is unusual because of the long latency between thyroidectomy and clinical presentation. ( info)

10/382. Primary hypoparathyroidism in two horses.

    Two Thoroughbred horses were presented with various clinical signs which included sweating, agitation, muscle twitching and synchronous diaphragmatic flutter. These signs were associated with profound hypocalcaemia. A diagnosis of primary hypoparathyroidism was made on the basis of low serum ionised calcium concentration, hyperphosphataemia and markedly reduced serum immunoreactive parathyroid hormone concentrations in the presence of normal renal function. Treatment with a combination of intravenous calcium and subsequently oral calcium, magnesium and a vitamin d analogue (dihydrotachysterol) for up to 65 days resulted in complete remission of clinical signs. Horse 1 was euthanased 12 months after the initial recognition of signs. Results of necropsy were unremarkable apart from an absence of detectable parathyroid tissue. Horse 2 returned to athletic activities while receiving only maintenance doses of oral calcium carbonate. ( info)
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