FRI698 Hypoparathyroidism Secondary To Covid-19

Abstract

Abstract Disclosure: M. Hussain: None. T.K. Reddy: None. A. Mohiuddin: None. D. Lovre: None. R. Galagan: None. Introduction: New onset adult hypoparathyroidism is most often caused by thyroid surgery or autoimmune illness. To date, little is known about the effect of the novel coronavirus (SARS-CoV-2) on parathyroid glands. Most recent hypotheses are that Covid-19 might affect the parathyroid glands directly through invasion of parathyroid gland tissues by SARS-CoV-2 virus or indirectly secondary to respiratory failure and chronic respiratory alkalosis. Case Report: We report the case of a 32-year-old male with post-viral hypoparathyroidism secondary to COVID-19.Only a few cases of COVID-19 induced hypoparathyroidism have been reported in the literature. Our patient was admitted to the hospital for severe and symptomatic hypocalcemia three weeks after a viral-like upper respiratory tract infection and diarrhea. He complained of paresthesias, muscle cramps and muscle weakness. He had no autoimmune or neck surgical history. Initial lab test results revealed a corrected calcium of 4.5 mg/dL (8.4-10.3 mg/dL), ionized calcium 2.4 mg/dL (4.5-5.3 mg/dL), PTH < 1.0 pg/mL (12-65 pg/mL), phosphorus 6.2 mg/dL (2.5-4.7 mg/dL), magnesium 1.6 mg/dL (1.5-2.6 mg/dL), Vit D, 25-hydroxy 17.3 ng/mL (30-100 ng/mL), and creatinine 1.13 mg/dL (0.7-1.4 mg/dL), consistent with hypoparathyroidism. An ECG showed QTc prolongation to 506 msec. SARS-coV-2/flu/RSV cepheid multiplex was negative, SARS-CoV-2 Spike Ab was positive. He had never received a COVID vaccine. The patient was admitted to ICU for IV calcium drip, oral calcium and calcitriol supplementation. He was transitioned to a medical ward when his severe hypocalcemia was corrected and he was ultimately discharged on oral calcitriol 1 mcg BID and calcium carbonate 1000 mg po TID. A thorough workup for a cause of the hypoparathyroidism was performed, including anti-PTH antibody, 21-hydroxylase antibody, TSI, and TPO antibody, all of which were negative. Genetic testing was performed, including CASR gene sequencing analysis and AIRE DNA sequencing, both of which were negative. After other causes of hypoparathyroidism were excluded, COVID-19 was reasoned to be the etiology of this patient’s hypoparathyroidism. Our case highlights a post-viral hypoparathyroidism secondary to COVID-19. Further studies are needed to elucidate the mechanistic relationship between COVID-19 and hypoparathyroidism. Presentation: Friday, June 16, 2023