Hypoparathyroidism and Pernicious Anaemia

Abstract

Seven patients with concomitant primary hypoparathyroidism and Addisonian pernicious anaemia have been described in the literature so far (4, 6, 7, 9, 12, 13).As the total number of patients with primary hypoparathyroidism published is rather smallaccording to Rasmussen and Reifenstein (8) about 85 -the coexistence of these two diseases can scarcely be due to mere coincidence.We have observed one patient suffering from primary hypoparathyroidism and pernicious anaemia. In addition, in order to study the effect on removal of the parathyroids on the functional and anatomical condition of the stomach, four patients with inadequetely treated post-operative hypoparathyroidism have been investigated. Case reports The patient with idiopathic hypoparathyroidism and Addisonian pernicious anaemiaThe patient was a hospital handyman born in 1932. His childhood development had been slightly slower than normal: he learnt to walk at the age of 1.5 years, to speak at 3 and failed twice in elementary school to gain promotion to the next form.

Autoimmune Hypoparathyroidism

“…Pernicious anemia is the most common 33,34,47,48,61,69,71,72 and usually manifests 5-10 years after hypoparathyroidism, 33 occasionally presenting during adult life. 48 Despite its early onset, the pernicious anemia is the "adult type," which is otherwise rare before age 20 years.…”

“…Distinction should be made between cases of true pernicious anemia, in which intrinsic factor is deficient, and those cases in which absorption of vitamin B 12 is impaired by steatorrhea or non-specific gastrointestinal defects. In 1964, Ikkala and colleagues 72 showed that these latter changes may also occur from postoperative hypoparathyroidism. Indeed, in other types of hypoparathyroidism, successful treatment of the hypocalcemia occasionally leads to improved absorption of fat and vitamin B 12 .…”

Mala absorción selectiva juvenil de vitamina B12

“…La anemia perniciosa es una enfermedad de individuos adultos pero puede encontrarse en. jóvenes en cuyo caso aparece en la segunda década de la vida asociada frecuentemente a disturbios endocrinos (hipoparatiroidismo, hipotiroidismo, enfermedad de Addison) (3)(4)(5)(6)(7)(8). Es más frecuente en niñas en quienes la moniliasis y la presencia de anticuerpos contra diversos órganos y contra factor intrínseco son fácilmente demostrables.…”