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Hypoparathyroidism presenting as recurring muscle aches and grossly elevated serum creatine kinase

Author: 
Dr. Singh, D. P., Dr. Rohit Kumawat, Dr. Nishant Verma and Dr. Pankaj
Subject Area: 
Health Sciences
Abstract: 

High serum CK levels are found in many muscular dystrophies as well as inflammatory, toxic, metabolic, and mitochondrial myopathies. The highest values are seen during attacks of myoglobinuria (“rhabdomyolysis”), a clinical syndrome of diffuse myalgia, myoglobinuria, and, often, renal failure. Idiopathic hyper CKemia indicates persistently elevated CK with no symptoms or minimal symptoms, such as muscle aches at rest or with exercise, muscle cramps, or stiffness. On examination, there should be no weakness, wasting, loss or increase of tendon reflexes, or fasciculations. We here present a case of 31 year old Indian male presented to us with complaints of muscle aches, easy fatiguability numbness in all 4 limbs for last four years. On investigation the patient had an elevated serum creatine kinase level but on evaluation no myopathy, weakness, wasting, loss or increase of tendon reflexes, or fasciculations were present. Patient’s PTH level was low and diagnosis of idiopathic hypoparathyriodism with Hyper CKemia without Myopathy was kept.

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