We report a case of a 51 year-old gentleman with increased serum creatine kinase (CK) due to hypocalcaemic tetany caused by idiopathic hypoparathyrodism. Raised CK (1738 u/L) was incidentally noted in this patient by his GP. He had ongoing symptoms of hypocalcaemia with intermittent tetanic spasms in his hands and scalp and easy fatigability for 2 years. His examination showed normal stature, no evidence of myopathy with normal deep tendon reflexes, Trousseaus sign was present while Chvosteks sign was absent. His electrocardiogram (ECG) revealed a slightly prolonged QTc of 497 milliseconds. His laboratory findings showed hypocalcaemia (1.08 mmol/L) and hyperphosphataemia (2.57 mmol/L) with low PTH (5 pg/ml) while his vitamin D levels were satisfactory. After supplementation with alfacalcidol and calcium carbonate his hypocalcaemia and hyper-CK-emia resolved and his symptoms improved. We suggested that elevation of his muscle enzymes was related to episodes of tetany he was having with his low calcium.
Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.