Korean Journal of Nephrology 2001;20(2):342-347.

증례 : 횡문근융해중을 동반한 급성 신부전으로 인해 악화된 특발성 부갑상선 기능저하증 1 예 (A Case of Acute Renal Failure Caused by Toxic Epidermal Necreolysis Combined with Rhabdomyolysis in A Patient with Idiopathic Hypoparathyroidism)

최종현(Jong Hyun Choi),박상민(Sang Min Park),김경천(Kyung Cheon Kim),최기영(Ki Young Choi),박세관(Sae Gwan Park),박종원(Jong Won Park),신영호(Young Ho Sin),이용희(Yong Hee Lee)

Abstract

Idiopathic hypoparathyroidism is extremely rare disease. We experienced an interesting case of idio- pathic hypoparathyroidism associated with acute renal failure caused by toxic epidermal necrelysis com- bined with rhabdomyolysis. This 36-years-old male patient was suffered from bullous erythematous scalding skin lesion on lower extremity, back, and chest. After 10 days, he was admitted with the chief complaints of generalized seizure, carpopedal spasm, stuporous mentality. Skin biopsy showed edematous change with extravasated erythrocytes in upper dermis and several individually necrotic keratinocytes. On laboratory finding, marked decreased serum PTH level were demonstrated. Increased muscle uptake of technetium-99m MDP were noticed on bone scan. Prolonged Q-T interval on electrocardiogram was also noted. We could diagnose his disease as severe hypocalcemia(hypocalcemic crisis) developed associated with acute renal failure caused by toxic epidermal necrolysis combined with rhabdomyolysis in patient with idiopathic hypoparathyroidism. He was treated by hydration, urine alkalinization, 2 times of hemodialysis and supplementary calcium, vitamin D during the admission.