Ding LN, Wang Y, Tian J, Ye LF, Chen S, Wu SM, Shang WB. Primary hypoparathyroidism accompanied by rhabdomyolysis induced by infection: A case report. World J Clin Cases 2019; 7(19): 3111-3119 [PMID: 31624762 DOI: 10.12998/wjcc.v7.i19.3111]
Corresponding Author of This Article
Wen-Bin Shang, MD, PhD, Professor, Department of Endocrinology, the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Chinese Medicine, 155 Hanzhong Road, Qinhuai District, Nanjing 210029, Jiangsu Province, China. wbshang@njucm.edu.cn
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 6, 2019; 7(19): 3111-3119 Published online Oct 6, 2019. doi: 10.12998/wjcc.v7.i19.3111
Primary hypoparathyroidism accompanied by rhabdomyolysis induced by infection: A case report
Li-Na Ding, Yi Wang, Jun Tian, Li-Fang Ye, Shi Chen, Shi-Min Wu, Wen-Bin Shang
Li-Na Ding, Yi Wang, Li-Fang Ye, Shi Chen, Wen-Bin Shang, Department of Endocrinology, the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Jun Tian, Department of General Surgery, Zhangjiagang Traditional Chinese Medicine Hospital affiliated with Nanjing University of Chinese Medicine, Zhangjiagang 215600, Jiangsu Province, China
Shi-Min Wu, Department of Gynecology and Obstetrics, Changshu Traditional Chinese Medicine Hospital affiliated with Nanjing University of Chinese Medicine, Changshu 215500, Jiangsu Province, China
Author contributions: Ding LN collected the data and contributed to the manuscript drafting and editing; Wang Y and Tian J contributed to the data collection of the case report; Shang WB contributed to the concept, designed the paper, reviewed the medical report, and made important suggestions on the data and content; Ye LF and Chen S contributed to the case analysis and data analysis; Wu SM edited the grammar of the manuscript and the modification of the word; All the authors approved the final manuscript submitted.
Informed consent statement: Informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wen-Bin Shang, MD, PhD, Professor, Department of Endocrinology, the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Chinese Medicine, 155 Hanzhong Road, Qinhuai District, Nanjing 210029, Jiangsu Province, China. wbshang@njucm.edu.cn
Telephone: +86-25-85811146 Fax: +86-25-85811146
Received: July 11, 2019 Peer-review started: July 17, 2019 First decision: August 2, 2019 Revised: August 12, 2019 Accepted: September 11, 2019 Article in press: September 11, 2019 Published online: October 6, 2019 Processing time: 79 Days and 22.9 Hours
Abstract
BACKGROUND
Primary hypoparathyroidism (HPT) is rarely seen in the clinic, and it can be combined with rhabdomyolysis. There are few reports about this phenomenon. Therefore, it is significant to explore the etiology that is conducive to early diagnosis, timely treatment, and preventing the recurrence.
CASE SUMMARY
A 63-year-old man was admitted to our hospital with a severe upper respiratory tract infection and progressing decreased myodynamia of the lower limbs. Blood tests showed creatine kinase > 32000 U/L, creatinine 207.8 µmol/L, calcium 1.28 mmol/L, myoglobin 558.7 ng/mL, and parathyroid hormone 0 pg/mL. He was diagnosed with primary HPT with rhabdomyolysis, and severe upper respiratory tract infection was considered to be the initial trigger. He responded well to supplementation of intravenous calcium gluconate and oral calcium as well as bedside hemodialysis, fluid hydration, infection control, protecting the liver, etc. Creatine kinase, myoglobin, and serum calcium returned to normal, and muscle strength improved significantly. Symptoms improved after symptomatic treatment.
CONCLUSION
Severe infection should be prevented, which is the key cause of rhabdomyolysis in patients with HPT.
Core tip: We described progressively decreased myodynamia and elevated muscle enzymes in a man with primary hypoparathyroidism. He was eventually diagnosed with rhabdomyolysis and acute kidney injury based on primary hypoparathyroidism. After bedside dialysis, antibiotic treatment, supplementation with blood calcium, and other symptomatic treatments, muscle strength recovered. Regular monitoring of blood calcium and prevention of infection are necessary to prevent recurrence.
