A Rapidly Progressive Cataract in a Patient with Autoimmune Hypoparathyroidism and Acute Liver and Renal Failure

Haviv, Yosef S.; Safadi, Rifaat; Zamir, Ehud

doi:10.1159/000013493

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…Cataract development is associated with the duration of hypocalcemic symptoms, chronic hypocalcemia and hyperphosphatemia, and the rate of change in the calcium-phosphorus ratio. 7 , 8 Hypoparathyroidism-related cataract formation is suspected to result from membrane damage caused by low levels of calcium in aqueous humor. 9 The lenticular Na + /K + pump is inhibited, leading to an inward flux of sodium and water; subsequently, lens fibers swell and dystrophic calcification occurs.…”

Section: Discussionmentioning

confidence: 99%

Hypocalcemic cataract secondary to idiopathic hypoparathyroidism in an adolescent

Zhang,

Yang,

Xie

et al. 2023

J Int Med Res

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Idiopathic hypoparathyroidism is a rare endocrine disorder characterized by hypocalcemia secondary to inadequate parathyroid hormone secretion. Hypocalcemia-related cataract is most often observed in patients with postoperative hypoparathyroidism, whereas primary hypoparathyroidism-related cataract is rare and displays slow progression. Cataract usually occurs in people aged 18 to 50 years. Here, we describe a 17-year-old boy with bilateral cataract and a history of hypocalcemic tetany who was diagnosed with idiopathic hypoparathyroidism. Phacoemulsification with implantation of a monofocal aspherical intraocular lens was performed in the right eye; 6 months later, it was performed in the left eye. Elevated phosphorus and diminished calcium were observed in blood and aqueous humor. A deep anterior chamber, relatively thin central corneal thickness, large white-to-white distance, and thin lens were also observed. During follow-up, neither eye displayed intraocular lens decentration; best-corrected visual acuity was 20/20 in both eyes. These findings suggest that ophthalmologists should be vigilant when hypocalcemic tetany and cataract are present, especially in adolescents and young adults.

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Section: Discussionmentioning

confidence: 99%

Hypocalcemic cataract secondary to idiopathic hypoparathyroidism in an adolescent

Zhang,

Yang,

Xie

et al. 2023

J Int Med Res

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“… 26 Historic observations also suggest that PSC can be associated with PTH disorders. 27 , 28 Disruption of calcium homeostasis in the lens has been shown experimentally to produce lens opacification via several mechanisms, including lens protein aggregation, enhanced migration of lens epithelial cells (LECs) onto the posterior capsule, abnormal differentiation of LECs into fibrocytes, lens fiber gap junction uncoupling, and loss of activity of calcium channels. 29 , 30 Paradoxically, both hypocalcemia and hypercalcemia have been observed in association with experimental cataract models and in other forms of human cataract.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D deficiency and posterior subcapsular cataract

Brown¹,

Akaichi²

2015

OPTH

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PurposeTo evaluate risk factors associated with posterior subcapsular cataract (PSC) development and the relationship between vitamin D deficiency and etiology of PSC.MethodsOf 195 consecutive patients from a private ophthalmology practice, diagnosed with PSC, serum vitamin D3 (25-OH D) levels were obtained for 175, and associations among risk factors, comorbidities, and PSC were assessed.ResultsIn all 175 PSC patients, mean 25-OH D levels were low (24 ng/mL ±11 SD) compared with age/sex-matched standards. Significant differences in 25-OH D levels were noted between PSC subjects taking/not taking calcium supplements, systemic steroids, osteoporosis medications, etc. Alone, smoking status and calcium channel blockers and/or topical steroids use made no significant difference in PSC subjects 25-OH D levels, but two or more of these factors were associated with lowered levels of 25-OH D (P<0.001). Low vitamin D was correlated with female sex, autoimmune disease, and non-skin cancer diagnosis, but not with age, or other comorbidities or medication use. In five early-stage PSC patients taking 5,000 IU of 25-OH D daily for vitamin D deficiency, there was resolution of their cataracts during the 2-year follow-up period.ConclusionVitamin D levels for most PSC patients fell below the 30 ng/mL calcium homeostasis threshold. Some comorbidities and non-ophthalmic interventions are associated with the development of PSC at less depressed levels of 25-OH D. In this series, vitamin D deficiency was associated with PSC cataract, suggesting that raising the level of vitamin D intake may reduce PSC incidence.

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“…76 In 1999, a patient was reported with an extremely rapid evolution of hypocalcemic cataracts when serum calcium and phosphorus concentrations were poorly controlled during acute idiopathic hepatic and renal failure. 79 APS1 and idiopathic hypoparathyroidism can also cause ectodermal problems that include dry and rough skin, 25 coarse and brittle hair, and lusterless, somewhat hypoplastic, distally split nails. 25,64,73,80 There may also be darkly pigmented skin 25,36 with hyperkeratosis.…”

Section: Non-endocrine Diseasesmentioning

confidence: 99%

Autoimmune Hypoparathyroidism

Whyte

2015

The Parathyroids

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A Rapidly Progressive Cataract in a Patient with Autoimmune Hypoparathyroidism and Acute Liver and Renal Failure

Cited by 11 publications

References 14 publications

Hypocalcemic cataract secondary to idiopathic hypoparathyroidism in an adolescent

Hypocalcemic cataract secondary to idiopathic hypoparathyroidism in an adolescent

Vitamin D deficiency and posterior subcapsular cataract

Autoimmune Hypoparathyroidism

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