Endocrinol Metab.  2014 Mar;29(1):91-95. 10.3803/EnM.2014.29.1.91.

Hypoparathyroidism and Subclinical Hypothyroidism with Secondary Hemochromatosis

• Jeong HK
• An JH
• Kim HS
• Cho EA
• Han MG
• Moon JS
• Kim HK
• Kang HC

• KMID: 2169357
• DOI: http://doi.org/10.3803/EnM.2014.29.1.91

Abstract

Hemochromatosis is an inherited genetic disorder of iron metabolism which can also occur as a secondary result of iron-overload. It leads to organ damage such as cardiomyopathy, liver cirrhosis, hypogonadism, and diabetes. This paper discusses a case of secondary hemochromatosis associated with repeated transfusions, presenting as asymptomatic hypoparathyroidism and subclinical hypothyroidism with multiple organ involvement. The 29-year-old female, who had severe aplastic anemia, received multiple transfusions totaling approximately 1,400 units of red blood cells over 15 years. During her routine laboratory examination, hypocalcemia was detected with decreased intact parathyroid hormone and increased thyroid stimulating hormone. Serum ferritin, iron, and total iron binding capacity had increased to 27,583.03 ng/mL, 291 microg/dL, and 389 microg/dL, respectively. She had unusually bronze skin and computed tomography revealed iron deposition in the thyroid, liver, and heart. Multiorgan involvement as seen in this case is rare in hemochromatosis associated with secondary transfusions. To the best of the author's knowledge, this is the first case report in Korea of hypoparathyroidism and subclinical hypothyroidism due to iron deposition in the parathyroid and thyroid gland.

Keyword

Hypoparathyroidism; Hypothyroidism; Hemochromatosis

MeSH Terms

Adult
Anemia, Aplastic
Cardiomyopathies
Erythrocytes
Female
Ferritins
Heart
Hemochromatosis*
Humans
Hypocalcemia
Hypogonadism
Hypoparathyroidism*
Hypothyroidism*
Iron
Korea
Liver
Liver Cirrhosis
Metabolism
Parathyroid Hormone
Skin
Thyroid Gland
Thyrotropin
Ferritins
Iron
Parathyroid Hormone
Thyrotropin

Figure

• 

  Fig. 1 Nonenhanced computed tomography scan revealed the high intensity of (A) the thyroid gland, (B) liver parenchyma with dilated inferior vena cava and intrahepatic vain, and (C) myocardium.

• 

  Fig. 2 T2-weighted magnetic resonance imaging revealed the dark signal intensity of liver, pancreas, spleen, and bone marrow.

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