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Proton pump inhibitor-induced hypocalcemic seizure in a patient with hypoparathyroidism.
MedLine Citation:
PMID:  21041166     Owner:  NLM     Status:  In-Data-Review    
Objective: To report a case of proton pump inhibitor-induced hypocalcemic seizure in a patient with hypoparathyroidism.Methods: We describe the clinical history, physical examination findings, and laboratory values of the patient and briefly review the relevant literature.Results: A 48-year-old woman with a history of postsurgical hypoparathyroidism who was taking calcium carbonate, 1500 mg 3 times daily, and cholecalciferol, 1200 IU daily, presented with a generalized seizure in the setting of hypocalcemia 12 days after initiating therapy with the proton pump inhibitor lansoprazole. Physical examination revealed a positive Chvostek sign. Electrocardiogram was notable for a prolonged QTc interval of 576 milliseconds. Laboratory data were notable for the following values: total serum calcium, 5.3 mg/dL; ionized calcium, 2.51 mg/dL; and intact parathyroid hormone, 5.8 pg/mL. The patient's condition responded to therapy with intravenous calcium gluconate, oral calcium carbonate, and calcitriol. As an outpatient she remained asymptomatic off lansoprazole, treated with calcium carbonate and calcitriol.Conclusions: Caution should be exercised in prescribing proton pump inhibitors to patients with a history of hypoparathyroidism treated with calcium carbonate supplementation because severe hypocalcemia is a potential adverse effect.
Sofiya Milman; Eric J Epstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  17     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2011-02-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  104-7     Citation Subset:  IM    
Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York.
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