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Hypoparathyroidism with Hypophosphatemia: A Clinical Paradox Due to Acquired Renal Hyperphosphaturia

Ann Intern Med. 1966;64(5):1066-1070. doi:10.7326/0003-4819-64-5-1066
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Postoperative hypoparathyroidism resulting in hypocalcemic tetany and high serum phosphorus often requires high doses of vitamin D for control. Subsequent toxicity with hypercalcemia is a complication familiar to both surgeon and internist. The following report concerns such a patient whose treatment inadvertently led to vitamin D intoxication sustained over a 2-year period. Withdrawal of vitamin D resulted in clinical improvement, but has been followed by an unexpected hypophosphatemia. Subsequent investigation revealed an isolated renal hyperphosphaturia and, although previously unreported, it is thought to be a direct consequence of vitamin D toxicity.

CASE REPORT: Patient Y. F., a 33-year-old white female


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