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Besides calcium and calcitriol supplementation, she was the first patient with severe hypocalcemic cardiomyopathy to be given off-label recombinant human parathyroid hormone (PTH) because of an elevated serum calcium\u2013phosphate product. We discuss the management and outcome of the patient and then present a brief review of similar previously reported cases. We also describe the pivotal role of calcium ion and the potential role of PTH in maintaining myocardial contractility, effective natriuresis, and possible pathogenic mechanisms contributing to heart failure secondary to hypocalcemia and hypoparathyroidism.<\/jats:p>","DOI":"10.1530\/eje-11-1094","type":"journal-article","created":{"date-parts":[[2012,3,20]],"date-time":"2012-03-20T04:29:59Z","timestamp":1332217799000},"page":"1113-1120","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":23,"title":["Use of recombinant human parathyroid hormone in hypocalcemic cardiomyopathy"],"prefix":"10.1093","volume":"166","author":[{"given":"Ghada T","family":"Ballane","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jad G","family":"Sfeir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Habib A","family":"Dakik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward M","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghada","family":"El-Hajj Fuleihan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","reference":[{"key":"1_42719919","first-page":"584","volume":"5","year":"1939","journal-title":"Helvetica medica acta","ISSN":"https:\/\/id.crossref.org\/issn\/0018-0203","issn-type":"print"},{"issue":"6868","key":"2_16882490","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1038\/415198a","volume":"415","author":"Bers","year":"2002","journal-title":"Nature; Physical Science (London)","ISSN":"https:\/\/id.crossref.org\/issn\/1476-4687","issn-type":"print"},{"key":"3_42719920","first-page":"69","volume":"20","year":"1967","journal-title":"LE JOURNAL MEDICAL LIBANAIS"},{"issue":"635","key":"4_4697344","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1136\/pgmj.54.635.633","volume":"54","author":"Brenton","year":"1978","journal-title":"Postgraduate Medical Journal","ISSN":"https:\/\/id.crossref.org\/issn\/0032-5473","issn-type":"print"},{"issue":"3","key":"5_4783083","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1136\/adc.54.3.236","volume":"54","author":"Walters","year":"1979","journal-title":"Archives of Disease in Childhood","ISSN":"https:\/\/id.crossref.org\/issn\/0003-9888","issn-type":"print"},{"issue":"4","key":"6_8206798","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1378\/chest.78.4.663","volume":"78","author":"Bashour","year":"1980","journal-title":"Chest","ISSN":"https:\/\/id.crossref.org\/issn\/0012-3692","issn-type":"print"},{"issue":"2","key":"7_8295488","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1378\/chest.79.2.225","volume":"79","author":"Giles","year":"1981","journal-title":"Chest","ISSN":"https:\/\/id.crossref.org\/issn\/0012-3692","issn-type":"print"},{"issue":"21","key":"8_8661475","first-page":"804","volume":"61","author":"Huddle","year":"1982","journal-title":"South African medical journal. 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