Glucocorticoids/levothyroxine sodium/zoledronic acid
- PDF / 169,989 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 2 Downloads / 179 Views
1 S
Glucocorticoids/levothyroxine sodium/zoledronic acid Osteoporosis, hypocalcaemia and unmasking of pre-existing hypoparathyroidism: case report
A 43-year-old woman developed osteoporosis following treatment with levothyroxine sodium and unspecified glucocorticoids as hormone replacement therapy for Sheehan syndrome (SS). Subsequently, she developed hypocalcaemia and unmasking of preexisting hypoparathyroidism following treatment with zoledronic acid for osteoporosis [not all routes, dosages and time to reaction onsets stated; outcomes not stated]. The woman was diagnosed with SS at the age of 35 years. Therefore, she started receiving hormone replacement therapy with levothyroxine sodium [thyroxine], oestrogen/ progesterone and unspecified glucocorticoids. At the age of 43 years, a, dual‑energy X‑ray absorptiometry scan revealed osteoporosis. Laboratory investigation revealed slightly lower levels of serum calcium and higher levels of phosphorus. The osteoporosis was suspected to have developed secondary to levothyroxine sodium and unspecified glucocorticoids. The woman was treated with calcium and vitamin D supplements. She also started receiving IV infusion of zoledronic acid 4mg over 15min. However, 48 hours after the zoledronic acid infusion, she developed perioral numbness and carpopedal spasm. She also had features of tetany in the form of positive Chvostek and Trousseau sign along with biochemical hypocalcaemia. The hypocalcaemia was considered to have developed secondary to zoledronic acid. She was treated with calcium gluconate leading to prompt resolution of symptoms. She was prescribed with calcium and calcitriol. She continued to experience recurrent symptomatic hypocalcaemia most likely due to inadequate compliance to treatment. Approximately two years after the zoledronic acid infusion, laboratory investigation revealed hypoparathyroidism and hypercalciuria. Zoledronic acid therapy had led to unmasking of pre-existing hypoparathyroidism. Viswanath SA, et al. Unmasking of hypoparathyroidism by zoledronic acid infusion in a patient with sheehan syndrome. Indian Journal of Endocrinology and Metabolism 24: 803507009 291-292, No. 3, Jun 2020. Available from: URL: http://doi.org/10.4103/ijem.IJEM_253_20
0114-9954/20/1826-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 17 Oct 2020 No. 1826
Data Loading...
