Korean J Nephrol.  2001 Mar;20(2):342-347.

A Case of Acute Renal Failure Caused by Toxic Epidermal Necreolysis Combined with Rhabdomyolysis in A Patient with Idiopathic Hypoparathyroidism

• Choi JH
• Park SM
• Kim KC
• Choi KY
• Park SG
• Park JW
• Sin YH
• Lee YH

Abstract

Idiopathic hypoparathyroidism is extremely rare disease. We experienced an interesting case of idiopathic hypoparathyroidism associated with acute renal failure caused by toxic epidermal necrelysis combined 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.

Keyword

Idiopathic hypoparathyroidism; Acute Renal failure; Rhabdomyolysis; TEN

MeSH Terms

Acute Kidney Injury*
Biopsy
Calcium
Dermis
Electrocardiography
Erythrocytes
Humans
Hypoparathyroidism*
Keratinocytes
Lower Extremity
Male
Rare Diseases
Renal Dialysis
Rhabdomyolysis*
Seizures
Skin
Spasm
Stevens-Johnson Syndrome
Stupor
Thorax
Vitamin D
Calcium
Vitamin D