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. 1972 Jul 8;107(1):54-56, 58.

Idiopathic hypoparathyroidism with impaired vitamin B12 absorption and neuropathy

John D L Gay, J David Grimes
PMCID: PMC1940694  PMID: 4339589

Abstract

A 68-year-old man presenting with chronic intermittent diarrhea and progressive ataxia was found to have idiopathic hypoparathyroidism. Intrinsic factor-resistant vitamin B12 malabsorption was demonstrated. Both the diarrhea and vitamin malabsorption were reversed by correction of hypocalcemia.

His neurological profile was a combination of peripheral nerve, posterior column and cerebellar deficits. He had calcifications in the dentate nuclei of the cerebellum. Possible etiological factors such as vitamin B12 deficiency, folic acid deficiency and steatorrhea have been excluded. Posterior column and cerebellar abnormalities improved with treatment. It is postulated that hypocalcemia causes functional, reversible spinal cord and cerebellar dysfunction.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blizzard R. M., Gibbs J. H. Candidiasis: studies pertaining to its association with endocrinopathies and pernicious anemia. Pediatrics. 1968 Aug;42(2):231–237. [PubMed] [Google Scholar]
  2. CLARKSON B., KOWLESSAR O. D., HORWITH M., SLEISENGER M. H. Clinical and metabolic study of a patient with malabsorption and hypoparathyroidism. Metabolism. 1960 Dec;9:1093–1106. [PubMed] [Google Scholar]
  3. Comin D. B., Hines J. D., Wieland R. G. Coexistent pernicious anemia and idiopathic hypoparathyroidism in a women. JAMA. 1969 Feb 10;207(6):1147–1149. [PubMed] [Google Scholar]
  4. GRASBECK R., KANTERO I., SIURALA M. Influence of calcium ions on vitamin-B12 absorption in steatorrhoea and pernicious anaemia. Lancet. 1959 Jan 31;1(7066):234–234. doi: 10.1016/s0140-6736(59)90056-x. [DOI] [PubMed] [Google Scholar]
  5. GRASBECK R., NYBERG W. Inhibition of radiovitamin B12 absorption by ethylenediaminetetraacetate (EDTA) and its reversal by calcium ions. Scand J Clin Lab Invest. 1958;10(4):448–448. doi: 10.3109/00365515809051257. [DOI] [PubMed] [Google Scholar]
  6. Hossain M. Neurological and psychiatric manifestations in idiopathic hypoparathyroidism: response to treatment. J Neurol Neurosurg Psychiatry. 1970 Apr;33(2):153–156. doi: 10.1136/jnnp.33.2.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Jones K. H., Fourman P. Effects of infusions of magnesium and of calcium in parathyroid insufficiency. Clin Sci. 1966 Feb;30(1):139–150. [PubMed] [Google Scholar]
  8. Knapp M. S., Gough K. R. An unusual neurological manifestation of hypocalcaemia. Lancet. 1967 Mar 4;1(7488):475–477. doi: 10.1016/s0140-6736(67)91095-1. [DOI] [PubMed] [Google Scholar]
  9. Muenter M. D., Whisnant J. P. Basal ganglia calcification, hypoparathyroidism, and extrapyramidal motor manifestations. Neurology. 1968 Nov;18(11):1075–1083. doi: 10.1212/wnl.18.11.1075. [DOI] [PubMed] [Google Scholar]
  10. Muldowney F. P., Donohoe J., Ryan C. Bone disease in intestinal malabsorption. Mod Treat. 1970 May;7(3):686–702. [PubMed] [Google Scholar]
  11. Muldowney F. P., McKenna T. J., Kyle L. H., Freaney R., Swan M. Parathormone-like effect of magnesium replenishment in steatorrhea. N Engl J Med. 1970 Jan 8;282(2):61–68. doi: 10.1056/NEJM197001082820203. [DOI] [PubMed] [Google Scholar]
  12. O'Malley B. W., Kohler P. O. Hypoparathyroidism. I. Postgrad Med. 1968 Oct;44(4):71–75. doi: 10.1080/00325481.1968.11696398. [DOI] [PubMed] [Google Scholar]
  13. Robertson D. M., Dinsdale H. B., Campbell R. J. Subacute combined degeneration of the spinal cord. No association with vitamin B12 deficiency. Arch Neurol. 1971 Mar;24(3):203–209. doi: 10.1001/archneur.1971.00480330031002. [DOI] [PubMed] [Google Scholar]
  14. Russell R. I. Hypoparathyroidism and malabsorption. Br Med J. 1967 Sep 23;3(5568):781–782. doi: 10.1136/bmj.3.5568.781. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Siurala M., Varis K., Lamberg B. A. Intestinal absorption and autoimmunity in endocrine disorders. Acta Med Scand. 1968 Jul-Aug;184(1-2):53–64. doi: 10.1111/j.0954-6820.1968.tb02422.x. [DOI] [PubMed] [Google Scholar]

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