Delayed post-surgical hypoparathyroidism mimicking ankylosing spondylitis: a case report

Hypoparathyroidism is a rare clinical condition characterized by parathyroid hormone insufficiency, decreased serum calcium, and increased serum phosphorus levels. Neck surgery is the most common cause of acquired hypoparathyroidism in adults. Postsurgical hypoparathyroidism is reported as one of the important complications in thyroid gland surgeries and if not diagnosed timely, may be associated with severe morbidity. The clinical manifestations of hypoparathyroidism are variable and may affect almost all organ systems. It is usually manifested by symptoms associated with hypocalcemia. The most common symptom is neuromuscular irritability, which includes paresthesias and muscle spasms in hands, feet, and around mouth. Rarely, some cases may present with inflammatory low back and neck pain, widespread pain, posture disorders, muscle weakness or, limited vertebral range of motion in the long term. Some patients may be misdiagnosed as spondyloarthropathy and may receive unnecessary treatments. In this case report, we present the clinical findings of a 55-year-old male patient with delayed post-surgical hypoparathyroidism who had been previously diagnosed ankylosing spondylitis and referred to our clinics for further treatment.