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It has been suggested that autoimmunity and genetic factors may play a specific role in the development of idiopathic hypoparathyroidism. We reported a case of idiopathic hypoparathyroidism complicated with chronic thyroiditis. The patient, a woman 40 years old, visited our clinic because of tetany of both hands and dizziness. She was of short stature with a round face. She also had a goiter, hypocalcemia, hyperphosphatemia and decreased parathyroidal function, but renal function was normal. Her TSH level was slightly high with a positive microsome test (x 1600), and the levels of thyroid hormones tended to be low. Based on Ellsworth-Howard test findings, a diagnosis of idiopathic hypoparathyroidism was made, with the complication of chronic thyroiditis confirmed by the thyroidal biopsy. Administration of l alpha-OH-D3 normalized the level of serum calcium. No special treatment was given for the chronic thyroiditis in order to observe its natural course. Her TSH returned to normal, and the level of thyroid hormones was increased to normal ranges. Tests were positive for anti-adrenal antibody and anti-gastric antibody. The complication of chronic thyroiditis, an autoimmune disease, and a positive finding for every antibody suggested the possible involvement of autoimmunity in the mechanism of development of idiopathic hypoparathyroidism. The administration of 1 alpha-OH-D3 resulted in an increase in the serum calcium level and also normalization of levels of TSH and thyroid hormones. Thus, it is likely that the elevation of the calcium ion or immunoregulation by active vitamin D may have induced the increase in thyroid hormone secretion.
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PMID:[A case of idiopathic hypoparathyroidism complicated with chronic thyroiditis]. 178 1

This experiment was undertaken to determine the connection between the breathing techniques practised in some methods of training for childbirth and the presence of certain undesirable side effects during labour. These symptoms, viz., dizziness, exhaustion, shortness of breath, "pins and needles", tremors and tetany, may be the result of hyperventilation and the ensuing hypocapnia (deficiency of CO2 in the blood) (Christophers, 1961).
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PMID:The effect of breathing techniques on the end-tidal percentage of carbon dioxide and its importance during labour. 2502 3

Tetany is a disorder with a very heterogeneous clinical manifestation. It includes neuromuscular hyperactivity, decreased attention, fatigue, constant anxiety. Attacks of tetany range from mild symptoms, which includes circumoral and distal paresthesias, hyperventilation, accompanied by shortness of breath, palpitation, dizziness, nausea and carpopedal spasm, through more severe symptoms like generalized seizures, loss of consciousness, muscle crumps to life-threatening emergencies like laryngospasm or arrhythmias. Tetany can be a result of many electrolyte disturbances, like hypocalcaemia, hypomagnesemia, hypokalaemia, alkalosis and electrolyte disturbances following hyperventilation. These disorders may occur in many clinical situations including diet deficiencies, alcoholism, endocrine diseases, genetic disorders, iatrogenic causes like proton pump inhibitors therapy and many, many others. It happens that tetany is diagnosed too late and therefore insufficiently cured. For these reason it deserves closer attention.
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PMID:[Tetany as a frequent cause of an emergency consultations--etiology, symptoms and cure]. 2607 73

Gitelman's syndrome is a rare autosomal recessive tubulopathy caused by a defect of the thiazide-sensitive sodium chloride co-transporter at the distal tubule, leading to hypokalemia, metabolic alkalosis, hypomagnesemia, hypocalciuria and low-to-normal blood pressure. Clinical features include transient periods of muscle weakness and tetany, dizziness, abdominal pains and constipation. Patients can also present with convulsions due to severe metabolic alkalosis or hypomagnesemia. Therefore, early recognition and treatment are important. Diagnosis of Gitelman's syndrome is usually made incidentally during adolescence or early adulthood based on clinical and biochemical findings. In this paper we present the case of a 23-year-old female patient referred to our nephrology department for severe hypokalemia. Complementary evaluation revealed hypokalemia, hypomagnesemia, metabolic alkalosis, increased chloride and sodium urinary excretion and reduced urinary calcium excretion with normal renal function. A diagnosis of Gitelman syndrome was established. Treatment included magnesium and potassium salts and potassium saving diuretics. In general, the long-term prognosis of Gitelman's syndrome is good if the patient adhere with the treatment.
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PMID:Gitelman's syndrome as a cause of poorly controlled hypokalemia. 2615 28