1999
DOI: 10.1159/000013493
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A Rapidly Progressive Cataract in a Patient with Autoimmune Hypoparathyroidism and Acute Liver and Renal Failure

Abstract: Cataract is a well-known complication of hypoparathyroidism, albeit the mechanism is obscure. The progression of cataract is typically slow in patients with idiopathic hypoparathyroidism. We describe a case of an extremely rapid evolution of typical hypocalcemic cataracts in a patient with familial autoimmune hypoparathyroidism during acute idiopathic hepatic and renal failure, while serum calcium and phosphorus were unbalanced. Physicians and ophthalmologists must be aware of cataracts developing rapidly in t… Show more

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Cited by 10 publications
(6 citation statements)
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References 14 publications
(30 reference statements)
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“…Cataract development is associated with the duration of hypocalcemic symptoms, chronic hypocalcemia and hyperphosphatemia, and the rate of change in the calcium-phosphorus ratio. 7 , 8 Hypoparathyroidism-related cataract formation is suspected to result from membrane damage caused by low levels of calcium in aqueous humor. 9 The lenticular Na + /K + pump is inhibited, leading to an inward flux of sodium and water; subsequently, lens fibers swell and dystrophic calcification occurs.…”
Section: Discussionmentioning
confidence: 99%
“…Cataract development is associated with the duration of hypocalcemic symptoms, chronic hypocalcemia and hyperphosphatemia, and the rate of change in the calcium-phosphorus ratio. 7 , 8 Hypoparathyroidism-related cataract formation is suspected to result from membrane damage caused by low levels of calcium in aqueous humor. 9 The lenticular Na + /K + pump is inhibited, leading to an inward flux of sodium and water; subsequently, lens fibers swell and dystrophic calcification occurs.…”
Section: Discussionmentioning
confidence: 99%
“… 26 Historic observations also suggest that PSC can be associated with PTH disorders. 27 , 28 Disruption of calcium homeostasis in the lens has been shown experimentally to produce lens opacification via several mechanisms, including lens protein aggregation, enhanced migration of lens epithelial cells (LECs) onto the posterior capsule, abnormal differentiation of LECs into fibrocytes, lens fiber gap junction uncoupling, and loss of activity of calcium channels. 29 , 30 Paradoxically, both hypocalcemia and hypercalcemia have been observed in association with experimental cataract models and in other forms of human cataract.…”
Section: Discussionmentioning
confidence: 99%
“…76 In 1999, a patient was reported with an extremely rapid evolution of hypocalcemic cataracts when serum calcium and phosphorus concentrations were poorly controlled during acute idiopathic hepatic and renal failure. 79 APS1 and idiopathic hypoparathyroidism can also cause ectodermal problems that include dry and rough skin, 25 coarse and brittle hair, and lusterless, somewhat hypoplastic, distally split nails. 25,64,73,80 There may also be darkly pigmented skin 25,36 with hyperkeratosis.…”
Section: Non-endocrine Diseasesmentioning
confidence: 99%