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Late diagnosis of chronic hypocalcemia due to autoimmune hypoparathyroidism
  1. Maxime Teisseyre1,
  2. Olivier Moranne1,2 and
  3. Sophie Renaud1
  1. 1Service de Néphrologie-Dialyse-Aphérèse, Hopital Universitaire de Nimes, Université de Montpellier, Nîmes, France
  2. 2Desbrest Institute Of Epidemiology and Public Health, Inserm, Montpellier, France
  1. Correspondence to Professor Olivier Moranne; olivier.moranne{at}chu-nimes.fr

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.

  • fluid electrolyte and acid-base disturbances
  • calcium and bone
  • immunology

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Footnotes

  • Contributors MT and SR had the idea for this case report. MT, SR and OM reviewed the patient’s clinical data, performed the literature search and wrote the manuscript. All authors made substantial contributions to interpretation of data. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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