[The "needle man": more than 40,000 injections in 40 years].

HISTORY AND ADMISSION FINDINGS

A now 65-year-old man had undergone a subtotal thyroidectomy over 40 years ago, which postoperatively resulted in hypoparathyroidism. His doctor began daily intravenous injections of a calcium preparation (1880 mg to 3760 mg calcium per day, over 40000 injections during this period), a regimen continued subsequently by a total of more than 15 other doctors for over 40 years. On admission the patient complained of oral paresthesias and paresthesias of the limbs.

INVESTIGATIONS

Low calcium and parathormone levels confirmed the diagnosis of hypoparathyroidism.

TREATMENT AND COURSE

Normal levels of calcium were achieved after a short course of 1.25-dihydroxycalciferol. This was followed by the administration of cholecalciferol and calcium. The patient soon became symptom-free and calcium levels returned to normal. Late sequelae have been calcification of the basal ganglia, first signs of nephrocalcinosis and bilateral cataract.

CONCLUSION

This case demonstrates that appropriate treatment of hypoparathyroidism [corrected] might not be given in every case.