Latent hypoparathyroidism in an osteoporotic patient with multiple endocrinopathies and secondary hemochromatosis due to multiple blood transfusions, unmasked by alendronate and glucocorticoid at adrenal crisis.
A 30-year-old normocalcemic man with hypopituitarism, hypogonadism, diabetes mellitus, and secondary hemochromatosis due to multiple blood transfusions was admitted because of adrenal crisis. After intravenous administration of saline and cortisol, the corrected serum level of calcium decreased to 7.3 mg/dl. This osteoporotic patient had been prescribed alendronate for radial bone fracture. Since the increase in intact PTH (68 pg/ml) was impaired compared to that seen in hypocalcemic patients with secondary hyperparathyroidism, we presume that the patient has had latent hypoparathyroidism, which was unmasked by the administration of glucocorticoid and bisphosphonate. With a supplemented dose of 1alpha-OHD3, the patient has been eucalcemic.
Tanimoto
Keiji
K
Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women's Medical University.
Okubo
Yumiko
Y
Harada
Chie
C
Saito
Hiroshi
H
Sata
Akira
A
Nishikawa
Aiko
A
Ohwada
Rina
R
Tsuiki
Mika
M
Yamamoto
Masaaki
M
Hashimoto
Etsuko
E
Sato
Kanji
K
Takano
Kazue
K
D000311:Adrenal Glands / Q000378:metabolism; D000328:Adult; D019386:Alendronate / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001862:Bone Resorption / Q000188:drug therapy; D002118:Calcium / Q000097:blood; D003920:Diabetes Mellitus / Q000378:metabolism; D004700:Endocrine System Diseases / Q000378:metabolism*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006432:Hemochromatosis / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007006:Hypogonadism / Q000378:metabolism; D007011:Hypoparathyroidism / Q000175:diagnosis* / Q000378:metabolism; D007018:Hypopituitarism / Q000378:metabolism; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy* / Q000378:metabolism; D010281:Parathyroid Hormone / Q000097:blood; D065227:Transfusion Reaction
D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; D010281:Parathyroid Hormone; D002118:Calcium; D019386:Alendronate