A Case of Pseudohypoparathyroidism Worsened by Rhabdomyolysis.

Won Jun Kim; Sin Je Moon; Hye Young Kim; Chang Beom Lee

doi:10.3803/jkes.2009.24.3.195

Case Report A Case of Pseudohypoparathyroidism Worsened by Rhabdomyolysis.: Won Jun Kim, Sin Je Moon, Hye Young Kim, Chang Beom Lee; Endocrinology and Metabolism 2009;24(3):195-200
DOI: https://doi.org/10.3803/jkes.2009.24.3.195
Published online: September 1, 2009

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Department of Internal Medicine, Hanyang University Guri Hospital, Korea.

Abstract

The term pseudohypoparathyroidism describes a rare disorder characterized by resistance to the action of immunoreactive parathyroid hormone (PTH) in peripheral tissue rather than a deficiency of PTH. Patients present with tetany, spasm, hypocalcemia, hyperphosphatemia, and Albright's hereditary osteodystrophy (AHO). We present a case of symptomatic hypocalcemia due to pseudohypoparathyroidism aggravated by rhabdomyolysis. A 21-year-old man presented with tetany, AHO phenotypes and an ankle infection. Rhabdomyolysis was confirmed by marked elevation of serum creatine phosphokinase, more than 10 times above normal. Spasm was observed and the serum value of total calcium was as low as 3.7 mg/dL and that of phosphate was as high as 7.0 mg/dL, and the peak level of PTH was at 80.4 pg/mL. Although not surveyed by Ellsworth-Howard test and molecular study, it was classified as pseudohypoparathyroidism type 1a or 1c. The clinical and laboratory abnormalities were corrected by vitamin D in addition to calcium. The patient's mother, sister, and grandmother had AHO phenotypes without clinical and biochemical manifestations. To the best of our knowledge, this is the first case by maternal inheritance that AHO phenotypes appear for three generations of a family in Korea.

Keywords: albright's hereditary osteodystrophy;hypocalcemia;pseudohypoparathyroidism;rhabdomyolysis;

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