Pseudohypoparathyroidism Presenting with Ventricular Arrhythmia: A Case Report

Abstract

Pseudohypoparathyroidism (PHP) is a rare disorder characterized by varying degrees of unresponsiveness to parathyroid hormone. Patients usually present with hypocalcemia-induced seizures or tetany, whereas no case of hypocalcemia-induced cardiac arrhythmia in PHP has been described to date. In this paper, we report the case of a male adolescent with PHP type 1a who presented with hypocalcemia-induced ventricular extrasystoles (bigeminy, trigeminy) and mild corrected QT interval prolongation. The patient had brachydactyly and his second fingers and toes were longer than the others, a finding consistent with PHP. Laboratory tests detected hypomagnesemia, as well as elevated levels of creatine kinase and lactate dehydrogenase. Ventricular arrhythmia and abnormal laboratory tests improved with calcium supplementation and vitamin D treatment. The findings in this patient suggest that hypomagnesemia may make patients with PHP more susceptible to hypocalcemia and may thus prompt a state of hypocalcemia-induced arrhythmia or other cardiac complications. Key words: Pseudohypoparathyroidism, arrhythmia, child Conflict of interest:None declared.

Subcutaneous Nodules and Stubby Hands

“…Diagnosis and prompt treatment of PHP is of utmost importance, as this prevents the fatal manifestations of hypocalcemia, which can include bronchospasm, laryngospasm, convulsions, and arrhythmias .…”

Spectrum of Disorders associated with Tetany

“…42 Tetany is also seen in PHP-PHP 1a, PHP1b, and PHP 2, which are associated with hypocalcemia and elevated PTH levels because of resistance to PTH. [43][44][45] Maternal primary hyperparathyroidism causing hypercalcemia during pregnancy can suppress fetal and neonatal parathyroid hormone secretion. Resultant transient hypoparathyroidism c aus es late n e o nat al hy p o c al ce mi c tetany.…”