Nora Daniel Bocchese, Fricke Daniele, Becker Jefferson, Gomes Irineo
Neurology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
Arq Neuropsiquiatr. 2004 Mar;62(1):154-7. doi: 10.1590/s0004-282x2004000100028. Epub 2004 Apr 28.
Myopathy due to idiopathic hypoparathyroidism is very unusual. We report on a 30 years-old man referred with complaints of sporadic muscle pain and mild global weakness for 10 years. His physical examination showed normal strength in distal muscle and slightly weakness in the pelvic and scapular girdles with no atrophy. Deep muscle reflexes were slightly hypoactive. Trousseau's and Chvostek's signs were absent. He had bilateral cataract and complex partial seizures. His laboratory tests showed decreased ionised and total calcium and parathyroid hormone and increased muscle enzymes. EMG and muscle biopsy was compatible with metabolic myopathy. After treatment with calcium and vitamin D supplementation he showed clinical, neurophysiological and laboratorial improvement.
patients with muscle symptoms, even when non-specific and with normal neurological examination, should have serum calcium checked, as myopathy due to idiopathic hypoparathyroidism, even being rare, is treatable and easy to diagnose.
特发性甲状旁腺功能减退所致的肌病非常罕见。我们报告一名30岁男性，因间歇性肌肉疼痛和轻度全身无力10年前来就诊。体格检查显示其远端肌肉力量正常，骨盆带和肩胛带轻度无力，无萎缩。深部肌肉反射略减退。无陶瑟征和克氏征。他有双侧白内障和复杂部分性发作。实验室检查显示离子钙和总钙、甲状旁腺激素降低，肌肉酶升高。肌电图和肌肉活检符合代谢性肌病。补充钙和维生素D治疗后，他在临床、神经生理和实验室检查方面均有改善。
有肌肉症状的患者，即使症状不特异且神经系统检查正常，也应检查血清钙，因为特发性甲状旁腺功能减退所致的肌病虽罕见，但可治疗且易于诊断。
