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MATERNAL HYPERPARATHYROIDISM AS A CAUSE OF NEONATAL TETANY: CASE REPORT AND REVIEW OF 29 CASES OF PARATHYROID ADENOMA

1955; Oxford University Press; Volume: 15; Issue: 6 Linguagem: Inglês

10.1210/jcem-15-6-680

1945-7197

Paul P. VanArsdel,

Esophageal and GI Pathology

VERY few reports of hypocalcemic tetany in the newborn associated with parathyroid overactivity in the mother have appeared in the literature. The first case was that of Friderichsen in 1938, in which medical investigation of a young woman was prompted by the presence of hypocalcemia and tetany in her infant (1). It is interesting that in this instance tetany did not develop until the infant was 5 months old, at which time cow's milk was substituted for breast milk. Only 3 other cases have been recorded, the most recent being that of Walton, in which neonatal tetany occurred in 2 siblings (2, 3). Similar observations have been made after the administration of Parathormone to gravid rats (4). This is a report of neonatal tetany in the third child of a 30-year-old woman whose hyperparathyroidism was unsuspected until almost four years later. R.W., the mother, aged 34, was admitted to the Medical Service of Presbyterian Hospital in April 1953, with a five-year history of polyuria, dysuria, recurrent chills, and flank pains. In 1948, she had been admitted to the Urology Service with left sided renal colic, vomiting, and fever. At that time the findings on physical examination were not remarkable. Intravenous and retrograde pyelograms were normal, and no calculi were seen. Determinations of serum calcium and phosphorus concentration were not made. Following discharge, her symptoms continued intermittently, and in 1952, one year prior to the final admission, the first of four calculi had been passed, preceded by renal colic. One calculus, analyzed at another hospital, was said to contain calcium. Recurrent episodes of renal colic on the left and right sides, malaise, urinary frequency, and occasional low-grade fever continued until the patient revisited the Urology Clinic in March 1953, her first return to this medical center in four years.