{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T10:12:50Z","timestamp":1779963170474,"version":"3.53.1"},"reference-count":22,"publisher":"Charles University in Prague, Karolinum Press","issue":"2","license":[{"start":{"date-parts":[[2018,9,14]],"date-time":"2018-09-14T00:00:00Z","timestamp":1536883200000},"content-version":"vor","delay-in-days":256,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2018,9,14]],"date-time":"2018-09-14T00:00:00Z","timestamp":1536883200000},"content-version":"tdm","delay-in-days":256,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["actamedica.lfhk.cuni.cz"],"crossmark-restriction":true},"short-container-title":["Acta Med. (Hradec Kralove, Czech Repub.)"],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p>Calcium is essential for proper muscular function and metabolism. Myopathy with high creatinkinase activity can be a rare manifestation of hypocalcemia of various origin, such as vitamin D deficiency, hypoparathyroidism, pseudohypoparathyroidism (PHP). 16-year old previously healthy boy was admitted to intensive care unit with convulsions lasting for three minutes and a transient loss of consciousness. Laboratory results revealed severe hypocalcemia (total S-Ca &lt; 1.0 mmol\/L; normal 2.2\u20132.6 mmol\/L), hyperphosphatemia (S-P 2.8 mmol\/L; normal 0.6\u20131.6 mmol\/L). Serum creatinkinase (S-CK) activity was 32 \u03bckat\/L (normal 0.57\u20132.45 \u03bckat\/L). Other basic biochemical parameters including creatinine, troponin, alkaline phosphatase were within normal values. Calcemia was gradually corrected within two weeks by intravenously and orally administered calcium and by cholecalciferol. S-CK reached a maximum of 222 \u03bckat\/L on day 4 and dropped to 7.2 \u03bckat\/L on day 14. Boy had no myalgias, neither clinical signs of myopathy. Echocardiography was normal with normal myocardial contractility, without any signs of calcification. The serum level of parathyroid hormone (S-PTH) was high (12 pmol\/L; normal 0.7\u20135.5 pmol\/L), fully compatible with the diagnosis of PHP. Molecular analysis revealed pseudohypoparathyroidism type Ib (PHPIb).In conclusion, manifest tetany and even mild myopathy with very high S-CK can occur in hypocalcemic patients and usually resolves after normalization of hypocalcemia.<\/jats:p>","DOI":"10.14712\/18059694.2018.51","type":"journal-article","created":{"date-parts":[[2018,9,14]],"date-time":"2018-09-14T15:22:11Z","timestamp":1536938531000},"page":"53-56","update-policy":"https:\/\/doi.org\/10.14712\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Severe Hypocalcemia and Extreme Elevation of Serum Creatinkinase in a 16-Year Old Boy with Pseudohypoparathyroidism Type 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