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Vitamin D deficiency masquerading as pseudohypoparathyroidism type 2
M Shriraam1, A Bhansali, P Velayutham
1Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh.
The Journal of the Association of Physicians of India
|July 23, 2004
Summary
Antiepileptic drugs can cause vitamin D deficiency, leading to hypocalcemia and hyperphosphatemia that mimics pseudohypoparathyroidism type 2. Treatment with calcium and vitamin D effectively normalized serum levels and restored phosphate regulation.
Area of Science:
- Endocrinology
- Clinical Medicine
- Pharmacology
Background:
- Antiepileptic drugs (AEDs) are commonly prescribed for seizure disorders.
- Long-term use of certain AEDs is associated with adverse effects on mineral metabolism.
- Vitamin D deficiency can result from AED-induced alterations in vitamin D metabolism.
Observation:
- A patient presented with hypocalcemia and hyperphosphatemia.
- Laboratory findings included increased tubular reabsorption of phosphate.
- The clinical presentation mimicked pseudohypoparathyroidism type 2.
Findings:
- The patient was diagnosed with vitamin D deficiency secondary to antiepileptic drug use.
- Treatment with calcium and vitamin D supplementation led to significant clinical improvement.
- Serum calcium and phosphate levels normalized following treatment.
- The phosphaturic response was reestablished, indicating restored renal phosphate handling.
Implications:
- This case highlights a critical iatrogenic cause of mineral and bone disorder.
- It underscores the importance of monitoring vitamin D and calcium levels in patients on long-term antiepileptic therapy.
- Early recognition and management can prevent complications and mimicry of genetic disorders like pseudohypoparathyroidism.