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[The "needle man": more than 40,000 injections in 40 years]
S Schiekofer1, P Heilmann, P P Nawroth
1Medizinische Klinik I, Universität Heidelberg, Germany.
Deutsche Medizinische Wochenschrift (1946)
|November 15, 2002
Summary
This case highlights a 40-year history of hypoparathyroidism treatment with intravenous calcium, leading to complications. Optimal treatment is crucial for managing this endocrine disorder and preventing long-term health issues.
Area of Science:
- Endocrinology
- Metabolic Bone Disease
Background:
- A 65-year-old male with a 40-year history of hypoparathyroidism following subtotal thyroidectomy.
- Chronic management involved daily intravenous calcium injections (1880-3760 mg/day) by multiple physicians.
Observation:
- Patient presented with oral and limb paresthesias.
- Investigations confirmed hypoparathyroidism with low calcium and parathormone levels.
Findings:
- Initial treatment with 1.25-dihydroxycalciferol normalized calcium levels.
- Subsequent cholecalciferol and calcium administration resolved symptoms.
- Long-term sequelae included basal ganglia calcification, nephrocalcinosis, and bilateral cataracts.
Implications:
- This case underscores the potential for suboptimal hypoparathyroidism management over extended periods.
- Highlights the importance of appropriate and vigilant treatment strategies for chronic endocrine conditions.
- Emphasizes the need for monitoring for long-term complications associated with hypoparathyroidism and its treatment.