Reversible Heart Failure and Rhabdomyolysis Caused by Primary Hypoparathyroidism during Lactation

Received: 2 December 2010, Accepted: 1 February 2011 Corresponding author: Dohee Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Dankook University College of Medicine, San 16-5, Anseo-dong, Dongnam-gu, Cheonan 330-715, Korea Tel: +82-41-550-3934, Fax: +82-41-556-3256, E-mail: [email protected] Hypocalcemia can be complicated, on rare occasions, by congestive heart failure and may also be associated with labor and lactation in some cases. Herein, we report a 30-year-old woman with hypocalcemia-induced heart failure secondary to primary idiopathic hypoparathyroidism precipitated by lactation. The patient presented with chest pain and paresthesia in both arms and legs during breast-feeding after her second delivery. She had severe hypocalcemia and low parathyroid hormone levels. Hypocalcemiainduced rhabdomyolysis further aggravated her hypocalcemia symptoms. The echocardiogram showed global hypokinesia with an ejection fraction of 47%. After calcium and vitamin D replacement, her symptoms and ventricular function improved. Hypocalcemia needs to be considered in patients with heart failure, because it is readily reversible. To the best of our knowledge, this is the first report of a patient with heart failure and rhabdomyolysis induced by primary hypoparathyroidism during lactation. (Endocrinol Metab 26:268-271, 2011)