A Rare Case of Association between Pseudohypoparathyroidism and Type 1 Diabetes Mellitus

Abstract

Background and Objective: Type 1 diabetes mellitus (T1DM) as an autoimmune disease is associated with hyperglycemia and pseudohypoparathyroidism with hypoglycemia. In this study, we report a rare case of association between type 1 diabetes and pseudohypoparathyroidism. Case Report: A 12.5-year-old female patient with a one-month history of polyuria and polydipsia was admitted with severe lethargy and vomiting, and due to high blood sugar and metabolic acidosis, Diabetic Ketoacidosis (DKA) was diagnosed. She was first treated with DKA protocol and then Basal- Bolus Protocol of insulin. The patient had a history of seizures due to hypocalcemia at the ages of 8 days and 2 months. In re-examination during hospitalization due to hypocalcemia-hyperphosphatemia and high parathyroid hormone, the diagnosis of false hypoparathyroidism was proposed and treatment with oral calcium tablet and calcitriol capsule was done and she was discharged after seven days with a good general condition. Conclusion: In patients with pseudohypoparathyroidism, in the event of a disturbance in glucose status, the pattern is usually hypoglycemia, but in our patient, this association was in the form of hyperglycemia and DKA in the context of T1DM, which is an indication of the rare association of these two diseases. Therefore, one should think about early diagnosis and proper treatment of this rare association.

Keywords

• pseudohypoparathyroidism
• type 1 diabetes mellitus
• hypocalcemia
• parathyroid hormone.