ACTA MEDICA
ACTA MEDICA
Acta Medica (Hradec Králové) je víceoborový vědecký recenzovaný časopis vycházející v angličtině. Acta Medica publikují review, původní články, stručná sdělení, případové studie a oznámení. Časopis byl založen v roce 1958 pod názvem Sborník vědeckých prací Lékařské fakulty Univerzity Karlovy v Hradci Králové. Je indexován v databázích Chemical Abstracts, CNKI, DOAJ, EBSCO, Hinari, Index Medicus, MEDLINE, Scopus a Ulrichsweb.

ACTA MEDICA, Vol 61 No 2 (2018), 53–56

Severe Hypocalcemia and Extreme Elevation of Serum Creatinkinase in a 16-Year Old Boy with Pseudohypoparathyroidism Type Ib

Štěpán Kutílek, Ivana Plášilová, Kristýna Hasenöhrlová, Hana Černá, Kristýna Hanulíková

DOI: https://doi.org/10.14712/18059694.2018.51
zveřejněno: 14. 09. 2018

Abstract

Calcium is essential for proper muscular function and metabolism. Myopathy with high creatinkinase activity can be a rare manifestation of hypocalcemia of various origin, such as vitamin D deficiency, hypoparathyroidism, pseudohypoparathyroidism (PHP). 16-year old previously healthy boy was admitted to intensive care unit with convulsions lasting for three minutes and a transient loss of consciousness. Laboratory results revealed severe hypocalcemia (total S-Ca < 1.0 mmol/L; normal 2.2–2.6 mmol/L), hyperphosphatemia (S-P 2.8 mmol/L; normal 0.6–1.6 mmol/L). Serum creatinkinase (S-CK) activity was 32 μkat/L (normal 0.57–2.45 μkat/L). Other basic biochemical parameters including creatinine, troponin, alkaline phosphatase were within normal values. Calcemia was gradually corrected within two weeks by intravenously and orally administered calcium and by cholecalciferol. S-CK reached a maximum of 222 μkat/L on day 4 and dropped to 7.2 μkat/L on day 14. Boy had no myalgias, neither clinical signs of myopathy. Echocardiography was normal with normal myocardial contractility, without any signs of calcification. The serum level of parathyroid hormone (S-PTH) was high (12 pmol/L; normal 0.7–5.5 pmol/L), fully compatible with the diagnosis of PHP. Molecular analysis revealed pseudohypoparathyroidism type Ib (PHPIb).In conclusion, manifest tetany and even mild myopathy with very high S-CK can occur in hypocalcemic patients and usually resolves after normalization of hypocalcemia.

klíčová slova: calcium; hypocalcemia; pseudohypoparathyroidism; creatinkinase; myopathy

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Severe Hypocalcemia and Extreme Elevation of Serum Creatinkinase in a 16-Year Old Boy with Pseudohypoparathyroidism Type Ib is licensed under a Creative Commons Attribution 4.0 International License.

210 x 297 mm
vychází: 4 x ročně
cena tištěného čísla: 150 Kč
ISSN: 1211-4286
E-ISSN: 1805-9694

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