Hypocalcemia in a Young Adult: A Case of Idiopathic Hypoparathyroidism with Concurrent Vitamin-D Deficiencyn

Abstract

Introduction: Hypocalcemia is a common electrolyte disturbance with diverse etiologies, including hypoparathyroidism and vitamin D deficiency. Idiopathic hypoparathyroidism, a rare nonsurgical cause, poses diagnostic and therapeutic challenges.

Case Presentation: A 22 year-old male with no known comorbidities presented with a history of diarrhoea and occasional muscle twitching for the last 3 months. He reported a weight loss of 10 kg over a two-month period. These complaints aggravated in the last few days, which brought him under emergency care. Initial investigations revealed severe hypocalcemia (serum calcium: 5.3 mg/dL), inappropriately low parathyroid hormone (PTH: 13 pg/mL), and low activated vitamin D (1, 25-dihydroxy vitamin D: 5.96 pg/mL), suggestive of hypoparathyroidism. Intravenous calcium infusion led to symptomatic improvement. Despite extensive gastrointestinal and metabolic evaluations, no underlying cause was identified, leading to a diagnosis of idiopathic hypoparathyroidism. The patient improved with oral calcium, calcitriol, and supportive management.

Conclusion: This case underscores the importance of recognizing hypocalcemia as a potential indicator of nonsurgical hypoparathyroidism and highlights the need for a systematic diagnostic and therapeutic approach for optimal long term management.