Endocrine Abstracts

Aim: Patients with hypoparatiroidism may admit to hospitals with different symptoms.In this report we presented 3 case of hypoparatiroidism with congestive heart failure,epilepsy and muscle pain.

Case 1: 31-year-old male admitted to hospital with dyspnea on lying down and evaluation revealed pericardial and pleural effusion. The patient was hospitalized to cardiology clinic with a prediagnosis of decompansated heart failure. In echocardiography ejection fraction was 17%, in laboratory tests calcium, phosphor and intact PTH (iPTH) values were 2.9 mg/dl (8.5–10.0), 6 mg/dl and <3 pg/ml respectively. He had no thyroidectomy or parathyroidectomy history. The patient was performed a cataract surgery 5 years ago. Patient was treated with calcium and calcitriol. After normalization of calcium patient’s ejection fraction rate was 35% 10 days later and 50% 3 months later.

Case 2: A patient with a history of epilepsy for 5 years admitted to neurology policlinic and routine laboratory evaluation revealed hypocalcemia (4.9 mg/dl) and patient referred to endocrinology policlinic in terms of hypocalcemia causes. In laboratory tests phosphor was 6 mg/dl and iPTH was <3 pg/ml. In medical history he has tingling in his hands and feet for 4–5 years and after an epileptic seizure he started to use anti epileptic drugs. Patient was treated with calcium and calcitriol. After normalizing calcium levels anti-epileptic drugs were ceased by neurology. He didn’t suffer epileptic seizures on his follow-up.

Case 3: 33-year-old male admitted to hospital with complaints of spasm in his hands and feet, hypocalcemia detected and patient referred to endocrinology policlinic. Laboratory investigation were as follow; calcium 6.3 mg/dl, phosphor 6 mg/dl, iPTH <3 pg/ml, and creatinine kinase 6134 U/l (20–200). Patient was treated with calcium and calcitriol. After normalizing calcium levels creatinine kinase levels and symptoms improved.

Conclusion: Most common finding of hypocalcemia is tetany.Hypocalcemia impair the balance between stimulus and contraction and causes various findings such as congestive heart failure. Increased creatinine kinase levels is reported in hypocalcemia. It should be keep in mind that epilepsy may be a symptom of hypocalcemia.