Idiopathic hypoparathyroidism mimicking diffuse idiopathic skeletal hyperostosis.

Area of Science:

• Endocrinology
• Rheumatology
• Skeletal Diseases

Background:

• Idiopathic hypoparathyroidism (IHP) is a rare endocrine disorder characterized by insufficient parathyroid hormone secretion.
• IHP can manifest with musculoskeletal complications, including diffuse ligamentous and entheseal ossifications.
• Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a condition primarily affecting older adults, marked by ossification of ligaments, particularly the anterior longitudinal ligament.

Observation:

• A 50-year-old male patient was diagnosed with idiopathic hypoparathyroidism.
• This patient had a prior diagnosis of Diffuse Idiopathic Skeletal Hyperostosis (DISH) at age 40.
• The patient presented with persistent neck, left shoulder, and left hip pain.

Findings:

• The patient's idiopathic hypoparathyroidism was associated with diffuse skeletal ossifications.
• The musculoskeletal pain was resistant to standard treatment with calcium and calcitriol.
• This case suggests a potential link or overlapping presentation between IHP and DISH in younger individuals.

Implications:

• This case underscores the importance of considering IHP in younger patients presenting with features suggestive of DISH.
• Further research may elucidate the relationship between parathyroid hormone deficiency and skeletal hyperostosis.
• Optimal management strategies for patients with co-existing IHP and DISH require further investigation.