Estrogen-Induced Tetany in Idiopathic Hypoparathyroidism

Burckhardt, P.; Rüedi, B; Felber, J. P.

doi:10.1159/000178681

Cited by 11 publications

(3 citation statements)

References 11 publications

(13 reference statements)

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“…Since then, oestrogens have been widely used in the treatment of osteoporosis. Oestrogens inhibit bone resorption induced by parathyroid hormone (PTH) in vivo (Orimo et al, 1972: Gallagher & Wilkinson, 1973 and in vitro (Atkins et al, 1972) and lower serum calcium levels (Young et al, 1968;Aitken et al, 1971;Riggs el al., 1972;Burckhardt et al, 1975;Goulding & McChesney, 1977). The antagonism of oestrogens to Correspondence: Dr S. Morimoto.…”

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confidence: 99%

The Effect of Oestrogens on Human Calcitonin Secretion After Calcium Infusion in Elderly Female Subjects

Morimoto

Tsuji

Okada

et al. 1980

Clinical Endocrinology

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The effect of oestrogen administration (4-6 weeks) on the response of human calcitonin (hCT) secretion to 5 min calcium infusions was studied in ten elderly women. There was no significant difference in mean basal plasma hCT levels before and after oestrogen administration. However, the mean increment in plasma hCT in response to calcium infusion (delta hCT) increased significantly (P < 0.001) from 21.9 +/- 6.6 (mean +/- SE) before treatment, to 79.6 +/- 15.5 ng/l after oestrogen administration. Mean serum calcium levels decreased significantly (P < 0.001) from 2.42 +/- 0.06 before to 2.19 +/- 0.07 mmol/l after oestrogen treatment. Mean plasma immunoreactive PTH (iPTH) levels increased significantly (P < 0.05) from 521 +/- 41 before to 696 +/- 96 ng/l after oestrogen treatment. To exclude out the possibility that the decreased serum calcium level itself might have influenced delta hCT, 1 alpha-hydroxycholecalciferol (1 alpha-OH-D3) was administered with oestrogens. While this resulted in a slight increase in serum calcium level, there was no significant difference in delta hCT in response to calcium infusion following oestrogen treatment alone, and after combination therapy of oestrogen and 1 alpha-OH-D3. The primary action of administered oestrogen may be in stimulating hCT secretion which results in a decrease in plasma calcium concentration and an increase in plasma iPTH level.

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confidence: 99%

The Effect of Oestrogens on Human Calcitonin Secretion After Calcium Infusion in Elderly Female Subjects

Morimoto

Tsuji

Okada

et al. 1980

Clinical Endocrinology

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“…However, the PTH results obtained in the third patient with discrepant basal PTH levels, who had tetanv of unknown origin, are consistent with the syndrome described by Nusino¬ witz & Klein (1973). Discrepant PTH responses to EDTA have also been observed in a second patient and have already been published (Burckhardt et al 1975). However, basal PTH levels were normal despite marked hypocalcaemia which led again to the diagnosis of idiopathic hypoparathyroidism.…”

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confidence: 60%

Parathyroid response to EDTA in hypoparathyroidism and in tetany

Burckhardt¹,

Tscholl-Ducommun²,

Rüedi³

1980

Acta Endocrinologica

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Abstract. The parathyroid response to an EDTA infusion was measured in 11 patients with hypoparathyroidism and 22 patients with normocalcaemic tetany, and compared to that of normal controls and of 23 patients with primary hyperparathyroidism. Despite comparable basal PTH values, the patients with hypoparathyroidism and the normocalcaemic patients, with tetany following thyroid surgery, responded less than normals to EDTA, while normocalcaemic patients with tetany due to psychogenic hyperventilation responded more than normals. In hypoparathyroidism, mainly three types of results were observed: no response (total hypoparathyroidism), diminished or delayed response (partial hypoparathyroidism), and discrepant results using different antisera in cases of idiopathic hypoparathyroidism, suggesting the secretion of immunologically abnormal PTH. In tetany due to psychogenic hyperventilation, parathyroid hyperreactivity might be explained by repeated stimulation through respiratory alkalosis. Although the EDTA test rarely improved the diagnostic accuracy of basal PTH measurements in primary hyperparathyroidism, it was useful for differentiating between latent hypoparathyroidism and tetany due to psychogenic hyperventilation, both presenting with normal plasma calcium.

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“…A subset of the patients complained of hypocalcemic symptoms in the perimenstrual phase. Though several investigators have reported similar clinical observation [14-18], there is only one systematic study and an isolated case report investigating relationship of serum calcium with menstruation in patients with hypoparathyroidism [19,20] and the results were variable. It was also suggested that hypocalcemic symptoms during perimenstrual phase might be a reflection of PMS rather than hypocalcemia [19].…”

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Menstruation associated hypocalcemic symptoms and serum calcium in patients with idiopathic hypoparathyroidism

Saha

Goswami

2014

BMC Endocr Disord

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BackgroundSome of the patients with idiopathic hypoparathyroidism (IHP) report symptoms of hypocalcemia during menstruation. There is limited data on this observation.MethodsTwenty six menstruating women with IHP and 26 healthy controls were questioned regarding symptoms suggestive of hypocalcemia during menstruation. Twelve patients and eight controls were asked to prospectively monitor symptoms suggestive of hypocalcemia and premenstrual syndrome (PMS) if any, over two consecutive menstrual cycles. Serum ionized calcium (SiCa++), total and albumin adjusted calcium and intact paratharmone (iPTH) were measured at eight points covering menstrual, immediate post-menstrual, mid-cycle and premenstrual phase.ResultsTwelve of the 26 (46.2%) patients with IHP reported hypocalcemic symptoms during menstruation as compared to none of the controls. During prospective monitoring, there was no specific trend of hypocalcemic symptoms with respect to the phase of menstrual cycle. The mean SiCa++, serum total and albumin-adjusted calcium, iPTH and inorganic-phosphorus measured over two menstrual cycles were not significantly different in either of the two study groups. None of the subjects had PMS.ConclusionWomen with IHP do not show any trend of hypocalcemic symptoms or fluctuations in serum calcium over different phases of menstrual cycles. Therefore, patients with hypoparathyroidism linking hypocalcemic symptoms with menstruation should be reassured regarding lack of this association.

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Estrogen-Induced Tetany in Idiopathic Hypoparathyroidism

Cited by 11 publications

References 11 publications

The Effect of Oestrogens on Human Calcitonin Secretion After Calcium Infusion in Elderly Female Subjects

The Effect of Oestrogens on Human Calcitonin Secretion After Calcium Infusion in Elderly Female Subjects

Parathyroid response to EDTA in hypoparathyroidism and in tetany

Menstruation associated hypocalcemic symptoms and serum calcium in patients with idiopathic hypoparathyroidism

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