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[Celiac disease revealed by hypocalcemia complicating total
thyroidectomy: a case report]
[Article in French]
Service Endocrinologie-Diabetologie, Hopital
La Rabta, 1007 Tunis, Tunisia.
In order to illustrate a particular
circumstance of diagnosis of celiac disease, we report the case of
54-year-old women with a history of thyroid enlargement with normal
thyroid function and positive anti-peroxidase antibodies.
Immediately after total thyroidectomy with preservation of the
parathyroid glands, she developed tetany with total serum calcium
level at 50mg/l. Intravenous calcium infusion increased the calcium
level and led to resolution of hypocalcemia-induced signs but there
was no result when calcium and vitamin D were taken orally. The
diagnosis of malabsorption was very probable in light of the family
history of celiac disease, the anemia and the hypoalbuminemia. The
diagnosis was confirmed by antibodies assay and endoscopy. The PTH
level was less than 1 pg/l and radiography showed signs of
hyperparathyroidism. Gluten-free diet, calcium and vitamin D led to
an improvement of serum calcium.
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