Hypoparathyroidism and Recurrent Hyperthyroidism

Spontaneous hyperthyroidism in a patient made hypoparathyroid by previous thyroid surgery has been reported only twice previously to our knowledge.1,2Cattell's statistics on the occurrence of postoperative hypoparathyroidism and the recurrence rate of hyperthyroidism suggest that this combination of endocrine abnormalities might develop about once in 3,000 patients following thyroidectomy for toxic goiter.3 An excess of thyroid hormone usually results in a negative calcium balance.4-8Hypercalcemia is unusual in the presence of intact parathyroid glands, but in their absence excess thyroid hormone regularly elevates serum calcium levels.9In our case, amelioration of symptoms of hypoparathyroidism despite a decreasing intake of calcium and vitamin D was an early indication of recurrent hyperthyroidism. Report of Case A 39-year-old white housewife was first seen on Feb. 19, 1958. She had had a subtotal thyroidectomy for a toxic nodular goiter in December, 1957. Following surgery, hypoparathyroidism and hypothyroidism developed. When we first saw the