Hypoparathyroidism and Subclinical Hypothyroidism with Secondary Hemochromatosis

Abstract

Hemochromatosis is an inherited genetic disorder of iron metabolism which can also occur as a secondary result of iron-overload. It leads to organ damage such as cardiomyopathy, liver cirrhosis, hypogonadism, and diabetes. This paper discusses a case of secondary hemochromatosis associated with repeated transfusions, presenting as asymptomatic hypoparathyroidism and subclinical hypothyroidism with multiple organ involvement. The 29-year-old female, who had severe aplastic anemia, received multiple transfusions totaling approximately 1,400 units of red blood cells over 15 years. During her routine laboratory examination, hypocalcemia was detected with decreased intact parathyroid hormone and increased thyroid stimulating hormone. Serum ferritin, iron, and total iron binding capacity had increased to 27,583.03 ng/mL, 291 µg/dL, and 389 µg/dL, respectively. She had unusually bronze skin and computed tomography revealed iron deposition in the thyroid, liver, and heart. Multiorgan involvement as seen in this case is rare in hemochromatosis associated with secondary transfusions. To the best of the author's knowledge, this is the first case report in Korea of hypoparathyroidism and subclinical hypothyroidism due to iron deposition in the parathyroid and thyroid gland.

Levels of thyroid hormone, ferritin and testosterone in Acute Myocardial Infarction (AMI) patients in north India

“…Deposition of iron in thyroid gland might be another reason for hypothyroidism in patients with AMI. 12 In the current study, we observed that serum ferritin levels were significantly increased in newly diagnosed AMI patients who presented with significantly low levels of T3. Severe cases of myocardial infarction (Group 1, LVEF<35%) presented with significantly lower level of T3 and higher levels of feritin in comparison to the low LVEF group (Group 2, LVEF 35-50%).…”

“…27 Iqbal et al reported an association between total iron store of the body and risk of AMI. 12 Serum ferritin is the best indicator of iron storage. Oxidative stress created by increased iron store of the body might be an important factor of coronary artery disease leading to AMI.…”

“…11 Hypothyroidism could result from deposition of iron in thyroid gland. 12 Therefore, a relation between thyroid hormone and iron storage might be playing an important role in pathogenesis of AMI. Even congenital hypothyroidism has been suspected to be associated with increased serum ferritin.…”

Hypocalcaemic cardiomyopathy: a description of two cases and a literature review

“…Our two cases were also included in the overall evaluation. A total of 57 articles describing 61 cases were found 2–58 . All publications were independently evaluated by two researchers (M. V. and L. R.).…”

Articles in 'Endocrinology and Metabolism' in 2014

“…Other excellent articles on basic endocrine research have also been published [ 60 , 61 , 62 ]. Finally, interesting case reports on patients with various endocrine diseases appeared in 2014 in ' Endocrinology and Metabolism ' [ 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ].…”