Rhabdomyolysis: A Complication of Parathyroidectomy and Calcium Supplementation

• Published in: JAMA : the journal of the American Medical Association Vol. 239; no. 7; p. 643
• Main Authors: Wooldridge, Thomas D, Bower, John D, Nelson, Norman C
• Format: Journal Article
• Language: English
• Published: United States American Medical Association 13-02-1978
• Subjects: Adult; Calcium Carbonate - adverse effects; Calcium Carbonate - therapeutic use; Calcium, Dietary - adverse effects; Female; Glomerulonephritis - therapy; Humans; Hyperplasia - therapy; Myoglobinuria - chemically induced; Myoglobinuria - etiology; Parathyroid Glands - pathology; Parathyroid Glands - surgery; Phosphorus - therapeutic use; Renal Dialysis - adverse effects; Surgical Procedures, Operative - adverse effects
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.1978.03280340063025

HYPOPHOSPHATEMIA may result in a number of pathologic conditions. Fuller et al1 have called attention to the fact that rhabdomyolysis may be precipitated by hypophosphatemia, particularly when accompanied by strenuous muscle work. In our patient, severe hypophosphatemia occurred secondary to parathyroidectomy and calcium replacement, resulting in an episode of rhabdomyolysis.Parathyroidectomy is frequently required by patients receiving longterm hemodialysis for control of renal osteodystrophy. To the best of our knowledge, rhabdomyolysis has not previously been reported as a complication of parathyroidectomy and calcium supplementation.Report of a CaseA 33-year-old woman receiving long-term hemodialysis was admitted to the University of Mississippi Medical Center on March 27, 1977, for parathyroidectomy. Membranous glomerulonephritis was diagnosed in 1959, requiring long-term hemodialysis in June 1973. Her course was complicated by severe hypertension, and in October 1973 she underwent a bilateral nephrectomy for uncontrollable hypertension.During the patient's dialysis course, her serum inorganic phosphorus