title: 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.
abstract: 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.
authors.affiliation: Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women's Medical University.
authors.forename: Keiji
authors.initials: K
authors.lastname: Tanimoto
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Okubo
authors.forename: Chie
authors.initials: C
authors.lastname: Harada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saito
authors.forename: Akira
authors.initials: A
authors.lastname: Sata
authors.forename: Aiko
authors.initials: A
authors.lastname: Nishikawa
authors.forename: Rina
authors.initials: R
authors.lastname: Ohwada
authors.forename: Mika
authors.initials: M
authors.lastname: Tsuiki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Etsuko
authors.initials: E
authors.lastname: Hashimoto
authors.forename: Kanji
authors.initials: K
authors.lastname: Sato
authors.forename: Kazue
authors.initials: K
authors.lastname: Takano
mesh_terms: 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
chemical_list: D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; D010281:Parathyroid Hormone; D002118:Calcium; D019386:Alendronate