Clinical Manifestations of Idiopathic Hypoparathyroidism
IDIOPATHIC hypoparathyroidism is an infrequently diagnosed disease with a high morbidity and a low mortality. Although secondary hypoparathyroidism became a prominent clinical entity with the advent of thyroid surgery, the primary spontaneous type continues to be uncommon. The scarcity of reported cases of idiopathic hypoparathyroidism was brought into focus by Steinberg and Waldron1 in 1952 when in their complete review of the literature they were able to find only 51 cases to which they added one case of their own. They adhered to the following criteria for the diagnosis of the disease: (1) low scrum calcium level; (2) high serum inorganic phosphorus level (greater than 5.0 mg. per cent for adults and 7.0 mg. per cent for patients under 16 years of age); (3) absence of renal insufficiency; (4) normal bones on roentgenograms (in order to exclude infantile rickets or adult osteomalacia); and (5) chronic tetany. T he following case presents many of the classic signs and symptoms of the disease.
A 58 year old, white, married woman was first admitted to the hospital on June 10, 1952, because of recurrent convulsive seizures during the preceding 27 years. The seizures were thoroughly characteristic of grand mal attacks except for an occasionally associated period of confusion and disorientation lasting for hours or for days which at times required emergency hospital care. The convulsions occurred three or four times yearly, and in between the more severe episodes she experienced frequent tightness and spasm of the muscles of the extremities. These . . .