case_images: PMC11444793_01
case_images: Albumin-adjusted serum calcium levels and interventions plotted over time.
case_images: CRIE2024-6375828.001.jpg
case_images: PMC11444793_01_CRIE2024-6375828.001.jpg
case_images: fig1
case_images: Table 1, initial laboratory findings revealed severe hypocalcemia (5.4 mg/dL) (8.8-10.2 mg/dL), with an albumin-corrected calcium level of 6.03 mg/dL (8.9-10.3 mg/dL), low ionized calcium (0.44 mmol/L) (1.0-1.30 mmol/L), elevated PTH (242 pg/mL) (19-88 pg/mL), and hyperphosphatemia (5.5 mg/dL) (2.5-4.9 mg/dL) but normal vitamin D-25 level (56 ng/mL) (>30 ng/mL). The patient's calcium levels and treatment are outlined in Figure 1.
case_images: Parathyroid response to hypocalcemia. In response to low calcium levels, the parathyroid gland increases parathyroid hormone (PTH) production. PTH then acts on several organs to increase total serum calcium. However, in this case, PTH level collected near the reimplanted gland was elevated, but it was not sustained in the periphery.
case_images: CRIE2024-6375828.002.jpg
case_images: PMC11444793_01_CRIE2024-6375828.002.jpg
case_images: fig2
case_images: This finding suggests an appropriate PTH response from the reimplanted gland, and that ongoing hypocalcemia may be due to insufficient PTH function to maintain systemic calcium levels or a peripheral interference with PTH level (Figure 2).