A 35-year-old woman with no past medical history presents with muscle cramps and perioral paresthesias. Vital signs show BP 118/76 mmHg, HR 88/min, RR 16/min, temperature 37.2°C. Serum calcium is 6.8 mg/dL, phosphate 5.2 mg/dL, PTH 15 pg/mL, and albumin 4.0 g/dL. Serum magnesium is normal. She denies neck surgery or radiation. Which of the following is the most likely cause of her hypoparathyroidism?
- A)Surgical removal of parathyroid glands during thyroidectomy
- B)Hypomagnesemia-induced PTH resistance
- C)Chronic kidney disease
- D)Autoimmune destruction of parathyroid tissueGABARITO
- E)Vitamin D deficiency
Explicação
This patient has idiopathic hypoparathyroidism due to autoimmune destruction of parathyroid tissue. The low calcium, high phosphate, and suppressed PTH in a young person with no surgical history is classic. Autoimmune hypoparathyroidism is part of the APS-1 sy... Ver explicação completa e trilha adaptativa →