Report: Hypoparathyroidism Can Appear with Lupus in Rare Cases

According to a story from AJMC, only a small number of cases of hypoparathyroidism have been reported alongside systemic lupus erythematosus (SLE). However, despite the overall rarity of the scenario, a recent case report serves as a reminder to physicians not to forget about the possibility. The report profiles a 19-year-old woman who was diagnosed with lupus and chose to seek medical attention following symptoms of myoclonus and a low fever.

About Systemic Lupus Erythematosus

Systemic lupus erythematosus, more commonly known simply as lupus, is an autoimmune disease that is characterized by a red facial rash. Symptoms of lupus include facial rash, swollen, painful joints, fatigue, fever, swollen lymph nodes, chest pain, hair loss, and mouth ulcers. Women are more frequently affected than men. Treatment may include avoiding sunlight, immune system suppressing drugs, and pain medication. Most people with lupus are able to control their disease effectively without overall lifespan being affected. To learn more about systemic lupus erythematosus, click here.

About Hypoparathyroidism

Hypoparathyroidism is a very rare condition in which the functionality of the parathyroid glands is impaired due to the insufficient production of the parathyroid hormone. Symptoms include an unusual tingling sensation around the mouth, hands, and feet called paresthesia. Other symptoms include cramps and muscle spasms of the hands and feet, insomnia, bone pain, fatigue, and headaches. Low calcium levels can cause dangerous health events, such as irregular heartbeat, spasms affecting the airway, and seizures. Treatment typically involves calcium, vitamin D, and parathyroid hormone supplementation. To learn more about hypoparathyroidism, click here.

About the Report

In February 2021, the patient informed her doctor that she had previously been treated for delayed menstruation with dydrogesterone. This had taken place 40 days before the onset of these new symptoms. She developed the characteristic rash of lupus and despite treatment with antihistamines, she did not improve. The doctors noted myoclonic movements affecting the patient’s tongue and legs. 

Testing revealed a prolonged QT interval, which is often an indicator of hypocalcemia. Hypocalcemia is a strong sign of hypoparathyroidism, and the doctors began to suspect this was the diagnosis since the patient had low levels of parathyroid hormone and normal phosphorus levels. The patient’s hypocalcemia was successfully treated. The doctors also diagnosed her with Hashimoto’s thyroiditis.

The researchers concluded that while seeing the two diseases together is rare, physicians need to be aware of the possibility since hypoparathyroidism can trigger potentially life-threatening complications. In most cases in which both disease states are present, hypoparathyroidism appears either just before or at the same time as lupus.

Check out the abstract of this case report here.

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