Primary hypoparathyroidism accompanied by rhabdomyolysis induced by infection: A case report

Table 1 The blood tests of the patient at admission and discharge

	Admission	Discharge	Follow up	Normal range
Leucocytes, /L	18.01 × 109	9.32 × 109	6.35 × 109	4-10 × 109
Neutrophil, %	90.6	72.9	70.2	50-70
Hemoglobin, g/L	119	107	103	120-160
AST, U/L	518	33	-	< 38
ALT, U/L	88	41	-	< 42
CK, U/L	> 32000	354	96	24-195
CK-MB, U/L	420	13	10	< 25
LDH, U/L	4864	226	234	135-225
Urea, mmol/L	7.2	11.31	10.62	1.7-8.3
Creatinine, µmol/L	212.1	134.5	137.3	44-110
Potassium, mmol/L	3.19	4.07	3.99	3.5-5.1
Calcium, mmol/L	1.27	2.13	2.44	2.1-2.95
Uric acid, µmol/L	688	631.8	579.3	200-420
Phosphorus, mmol/L	2.21	1.47	-	0.87-1.45
Myoglobin, ng/mL	558.7	141.5	58.6	17.4-105.7
25(OH)D, ng/L	25.49	-	30.38	-
PTH, pg/mL	0	0	0	12.0-88.0
CTn I, ng/mL	0.2	0.04	-	< 0.04

LDH: Lactate dehydrogenase; PTH: Parathyroid hormone; CK-MB: Creatine kinase isoenzyme; ALT: Alanine transaminase; AST: Aspartate transaminase; CK: Creatine kinase; CTn I: Cardiac troponin I.

Table 2 Reported cases of primary hypoparathyroidism with rhabdomyolysis

Ref.	Age/sex	Year	Main symptoms	CK	Calcium	Trigger	Treatment	Follow up
Liu et al[5]	53/M	1983	Leg pain, swelling, erythema of extremity	45000	1.175	Cellulitis	Ergocalciferol (100000 U/d), gluconate calcium (20 g/d)	Normal
Akmal[7]	45/F	1993	Tiredness, weakness,inappropriate, behavior	26080	1.025	None	Calcium gluconate and vitamin D2	Normal
Hirata et al[13]	30/M	2001	Tetany, hyporeflexia, fatigue	3540	1.2	None	Calcium and 1α-hydroxyvitamin D3	Normal
Labarthe et al[10]	4 m/M	2006	Muscular pains, areflexia	10960	1.2	Fasting	Alfacalcidol (20 μg/d)	Nuclear cataract
Naiki et al[8]	2/F	2014	Tetany	9577	1.48	Infection	Intravenous fluids	Recurrence (3 yr old)
van Vliet et al[9]	20/F	2017	Dyspnea, muscle weakness, vomiting	193936	1.48	Viral gastroenteritis	Intravenous hydration, calcium	Recurrence 14 wk later
Sumnu et al[6]	26/M	2015	Pain and cramps in the legs, nausea, vomiting	262000	0.925	Tetany	Calcium and calcitriol, hydration	Hypercalcemia
Kutílek et al[19]	16/M	2018	Convulsions, transient loss of consciousness	1920	< 1	None	Calcium, cholecalciferol	Normal

F: Female; M: Male; CK: Creatine kinase.