Hypoparathyroidism in a patient presenting with severe myopathy and skin rash. Case report and review of the literature

Syriou, Vassiliki; Kolitsa, Asimina; Pantazi, L.; Pikazis, Dimitrios

doi:10.14310/horm.2002.11154

Cited by 20 publications

(11 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Serum CK levels may be increased secondary to muscle damage from sustained tetany. Hyporeflexia or areflexia is usually present and contrasts with the hyperreflexia in hyperparathyroidism (Syriou et al, 2005). …”

Section: Step 1: Overview and Understanding Of Myopathies In Systemicmentioning

confidence: 99%

Stepwise Approach to Myopathy in Systemic Disease

Chawla¹

2011

Front. Neur.

View full text Add to dashboard Cite

Muscle diseases can constitute a large variety of both acquired and hereditary disorders. Myopathies in systemic disease results from several different disease processes including endocrine, inflammatory, paraneoplastic, infectious, drug- and toxin-induced, critical illness myopathy, metabolic, and myopathies with other systemic disorders. Patients with systemic myopathies often present acutely or sub acutely. On the other hand, familial myopathies or dystrophies generally present in a chronic fashion with exceptions of metabolic myopathies where symptoms on occasion can be precipitated acutely. Most of the inflammatory myopathies can have a chance association with malignant lesions; the incidence appears to be specifically increased only in patients with dermatomyositis. In dealing with myopathies associated with systemic illnesses, the focus will be on the acquired causes. Management is beyond the scope of this chapter. Prognosis is based upon the underlying cause and, most of the time, carries a good prognosis. In order to approach a patient with suspected myopathy from systemic disease, a stepwise approach is utilized.

show abstract

Section: Step 1: Overview and Understanding Of Myopathies In Systemicmentioning

confidence: 99%

Stepwise Approach to Myopathy in Systemic Disease

Chawla¹

2011

Front. Neur.

View full text Add to dashboard Cite

show abstract

“…Thus, previous studies suggest that hypocalcemia may cause myopathy (16, 17), while hypercalcemia in hyperparathyroidism impairs gait speed (18). We have previously reported that fluctuations in plasma calcium levels occurred, which occasionally resulted in mild hypercalcemia among patients of the therapy group with intact PTH (11).…”

Section: Discussionmentioning

confidence: 98%

Correlations Between Changes in Undercarboxylated Osteocalcin and Muscle Function in Hypoparathyroidism

Harsløf

Sikjær

Mosekilde

et al. 2016

Int J Endocrinol Metab

View full text Add to dashboard Cite

BackgroundMuscles and bones are interconnected. Recent studies suggest that undercarboxylated osteocalcin from bone may affect muscle mass and strength. There are, however, no prospective human data on this relationship.MethodsWe previously treated patients with hypoparathyroidism with intact Parathyroid Hormone (PTH) or placebo in a six-month randomized, placebo-controlled trial and demonstrated a marked increase in undercarboxylated osteocalcin (ucOC) in the PTH-treated group. We therefore investigated if this increase correlated with changes in muscle mass, strength or function. Primarily, the muscle mass using Dual energy X-ray Absorptiometry (DXA) was measured and the maximal voluntary isometric muscle strength at the upper and lower extremities, using dynamometry, was assessed. Furthermore, repeated chair stands test, Timed Up and Go test were performed and postural stability using a stadiometer was assessed. Finally, the relationship between change in ucOC or the ratio of the changes in ucOC and total OC (ucOC%/OC%) and different measures of muscle function were analyzed, using regression analyses.ResultsThe findings indicated that ucOC%/OC% was positively and significantly associated with percentage change in max force production during elbow extension (β = 0.28, P = 0.034), however, all other associations were non-significant.ConclusionsGiven the number of statistical tests that were carried out, our one significant finding may represent a false positive. Thus the results do not support the role of ucOC in muscle function in humans with hypoparathyroidism. Our results are inconsistent with previous data from a human cross-sectional study; however, cross-sectional studies, do not allow for inference of causality. The analyses should be repeated in larger, randomized trials including healthy individuals.

show abstract

“…90,92,97,98 In a few cases, evidence of myopathy including early recruitment of motor units was described. 89,93 Similarly, muscle biopsies were normal in some cases 85,88,96,98 while other cases showed various changes consistent with mild, non-specific myopathy including atrophic and/or necrotic muscle fibers, internal nuclei, and inflammatory cell infiltrate. 89,[91][92][93]97 Notably, all reported cases were in patients with marked hypocalcemia, and therapeutic increase of serum calcium levels led to a decrease in muscle enzymes in all cases with normalization in most.…”

Section: Hypoparathyroidism-associated Myopathymentioning

confidence: 96%

“…89,93 Similarly, muscle biopsies were normal in some cases 85,88,96,98 while other cases showed various changes consistent with mild, non-specific myopathy including atrophic and/or necrotic muscle fibers, internal nuclei, and inflammatory cell infiltrate. 89,[91][92][93]97 Notably, all reported cases were in patients with marked hypocalcemia, and therapeutic increase of serum calcium levels led to a decrease in muscle enzymes in all cases with normalization in most. In two particularly illustrative cases, patients intermittently discontinued calcium therapy; CPK levels rose in concert with the fall in serum calcium and then decreased with resumption of therapy.…”

Section: Hypoparathyroidism-associated Myopathymentioning

confidence: 96%

“…[85][86][87][88][89][90][91][92][93][94][95][96] Neuromuscular exam has revealed additional signs including increased muscle tone 87,94 and decreased distal tendon reflexes. 88,92 Common to all these case reports is a significant elevation of circulating muscle enzyme levels, particularly creatine phosphokinase (CPK), which has been reported at levels 1.5 to 10 times greater than the upper limit of normal.…”

Section: Hypoparathyroidism-associated Myopathymentioning

confidence: 99%

See 1 more Smart Citation