Idiopathic hypoparathyroidism in black South Africans

The spectrum of idiopathic hypoparathyroidism in black South Africans is described. Twelve patients were seen over a seven-year period. Major presenting features were tetany in 11, epilepsy in four, congestive cardiac failure in three, cataracts in four, neuropsychiatric disease in two, and basal ganglia calcification in four. Hypocalcaemia and hyperphosphataemia were apparent in all subjects at presentation. Parathyroid hormone levels were absent or inappropriately low in all. Important features highlighted were the long duration of symptoms before diagnosis, the suppression of tetany by treatment with diphenylhydantoin, the association of idiopathic hypoparathyroidism and epilepsy in adults, and the occurrence of reversible cardiac muscle dysfunction.