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Hypoparathyroidism and elevated muscle enzymes

E Shane, K A McClane, M R Olarte

    Neurology
    |February 1, 1980
    PubMed
    Summary
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    This study investigated a patient with hypocalcemia and elevated sarcoplasmic enzymes. Treatment with calcium and vitamin D normalized enzyme levels, suggesting a link between calcium and muscle enzyme activity in hypoparathyroidism.

    Area of Science:

    • Endocrinology
    • Biochemistry
    • Neuromuscular Disorders

    Background:

    • Idiopathic hypoparathyroidism characterized by hypocalcemia and low parathyroid hormone levels.
    • Elevated serum activity of muscle-associated enzymes, creatine phosphokinase (CPK) and lactic dehydrogenase (LDH), without muscle weakness.
    • Normal muscle biopsy findings on morphologic and histochemical examination.

    Observation:

    • A single patient presented with hypocalcemia and increased serum sarcoplasmic enzyme activity.
    • Despite elevated enzyme levels, the patient exhibited no muscle weakness.
    • Diagnostic workup confirmed idiopathic hypoparathyroidism with characteristic hormonal responses.

    Findings:

    • Serum CPK and LDH levels significantly decreased with calcium and vitamin D treatment.

    Related Experiment Videos

  • Strong negative correlations were observed between serum calcium levels and CPK (r=-0.88) and LDH (r=-0.64) activity.
  • These correlations were statistically significant (p < 0.01).

    • Implications:

    • This case highlights a potential biochemical link between calcium homeostasis and muscle enzyme activity in hypoparathyroidism.
    • It suggests that elevated sarcoplasmic enzyme levels in hypocalcemia may be a reversible biochemical finding rather than indicative of primary muscle disease.
    • Further research could explore the mechanisms underlying this enzyme elevation and its resolution with calcium repletion.