Late diagnosis of chronic hypocalcemia due to autoimmune hypoparathyroidism.

Abstract

Hypoparathyroidism is most often the result of postsurgical damage to the parathyroid glands but may occasionally be autoimmune hypoparathyroidism. In the latter context, activating antibodies directed against the calcium-sensing receptor (CaSR) have been described. We hereby present the case of a patient suffering from chronic recurrent muscle cramps and paresthesia, presenting for a seizure due to hypocalcaemia. After eliminating the possibility of a genetic disorder, we searched for autoimmune hypoparathyroidism as there was no obvious cause of hypoparathyroidism. The search for anti-CaSR antibodies was positive. There was no argument for autoimmune polyendocrine syndrome type 1 so we concluded that it was isolated autoimmune hypoparathyroidism caused by activating antibodies to the CaSR. The patient was treated with vitamin D and calcium supplementation. The search for complications of hypoparathyroidism and hypercalciuria revealed basal ganglia calcification. The patient's hypocalcaemia is now being kept under control with oral supplementation.

• Authors: Maxime Teisseyre, Olivier Moranne, Sophie Renaud
• Journal: BMJ case reports (BMJ Case Rep) Vol. 14 Issue 6 (Jun 30 2021) ISSN: 1757-790X [Electronic] England
• PMID: 34193455 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Receptors, Calcium-Sensing
• Calcium

Topics

• Calcium
• Delayed Diagnosis
• Humans
• Hypercalciuria
• Hypocalcemia (diagnosis, drug therapy, etiology)
• Hypoparathyroidism (complications, diagnosis, drug therapy)
• Receptors, Calcium-Sensing