Refractory hypocalcemia precipitated by dual infection with typhoid fever and hepatitis A in a patient with congenital hypoparathyroidism  

作　　者：Suman S Karanth Ram Bhat Anurag Gupta 

机构地区：[1]Kasturba Medical College,Manipal,Manipal University,Karnataka,India

出　　处：《Asian Pacific Journal of Tropical Medicine》2012年第8期667-668,共2页亚太热带医药杂志（英文版）

摘　　要：We present this rare occurrence of a 17 yr old boy,a known case of congenital hypoparathyroidism, who presented with fever and jaundice for 8 days and 2 episodes of generalised tonic-clonic seizures.Premorbidly patient was on regular oral calcium supplementations with normal serum calcium levels.Investigations revealed severe hypocalcaemia(3.2 mg/dL),low 25 hydroxyvitamin D levels and hypomagnesacmia.The marked elevation of serum bilirubin was accompanied by derangement of liver enzymes.Microbiological investigations were confirmatory for both hepatitis A and typhoid fever.In spite of the aggressive management with intravenous calcium gluconate infusion,refractory hypocalcaemia persisted with recovery only after gradual decline in the bilirubin levels.We inferred that the cholestatic process produced by both acute viral hepatitis A and typhoid fever precipitated this state of refractory hypocalcaemia in the previously well preserved patient.We present this rare occurrence of a 17 yr old boy,a known case of congenital hypoparathyroidism, who presented with fever and jaundice for 8 days and 2 episodes of generalised tonic-clonic seizures.Premorbidly patient was on regular oral calcium supplementations with normal serum calcium levels.Investigations revealed severe hypocalcaemia(3.2 mg/dL),low 25 hydroxyvitamin D levels and hypomagnesacmia.The marked elevation of serum bilirubin was accompanied by derangement of liver enzymes.Microbiological investigations were confirmatory for both hepatitis A and typhoid fever.In spite of the aggressive management with intravenous calcium gluconate infusion,refractory hypocalcaemia persisted with recovery only after gradual decline in the bilirubin levels.We inferred that the cholestatic process produced by both acute viral hepatitis A and typhoid fever precipitated this state of refractory hypocalcaemia in the previously well preserved patient.

关 键 词：REFRACTORY HYPOCALCEMIA TYPHOID FEVER Hepatitis A 

分 类 号：R512.61[医药卫生—内科学] R516.3[医药卫生—临床医学]