REFRACTORINESS TO ANTITETANIC THERAPY IN A CASE OF SURGICAL HYPOPARATHYROIDISM

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Abstract
THE advent of dihydrotachysterol entirely revolutionized the treatment of hypoparathyroidism. According to Albright and Reifenstein (1) this agent is administered in a dosage of 3 cc. daily until calcium appears in the urine, at which time the dosage is decreased to a maintenance level of approximately 1 cc. three to seven times weekly, depending upon the degree of hypercalciuria as determined by the Sulkowitch test. Additional measures, such as a high calcium and low phosphorus intake, and the administration of aluminum hydroxide, vitamin D, ammonium chloride and desiccated thyroid have frequently proved useful. Of these, vitamin D or vitamin D2 (calciferol) have been used with particular frequency and are generally considered as effective as dihydrotachysterol in the management of chronic tetany. The following case of hypoparathyroidism is deemed worthy of reporting because of refractoriness to conventional antitetanic therapy, including large doses of dihydrotachysterol, and massive doses of vitamin D.