Congenital hypoparathyroidism presenting with stridor and severe growth failure in an infant: A Rare Case

Abstract

Background: Congenital hypoparathyroidism is a rare endocrine disorder characterized by hypocalcemia due to deficient secretion or action of parathyroid hormone. The clinical manifestations of this disorder are variable in nature and clinical presentation; however, the most common signs/symptoms of symptomatic cases include seizures, tetany and muscle twitching. The presence of stridor secondary to a laryngospasm as a presentation of congenital hypoparathyroidism is uncommon and frequently missed, particularly when other neurological problems do not exist.

Case Presentation: A six-month-old female infant, born via lower uterine segment cesarean section at 35 weeks gestation to a diabetic mother, presented to our hospital with severe growth failure (5 kg), feeding difficulties, respiratory distress and stridor. Her neonatal period was complicated by respiratory distress and MRSA sepsis, which required admission to a neonatal ICU. After that, she was managed for gastroesophageal reflux and a small atrial septal defect, but had persistent difficulties with feeding and breathing. When she was admitted to our unit, she had no evidence of lower respiratory disease; her chest radiograph was normal. Laboratory results revealed significant hypocalcemia, very low levels of serum PTH and normal levels of vitamin D, thus confirming the diagnosis of congenital hypoparathyroidism.

Conclusion: This case highlights a rare presentation of congenital hypoparathyroidism with stridor and severe growth failure without seizures. Clinicians should consider hypocalcemia in infants presenting with unexplained stridor and feeding difficulties. Early diagnosis and appropriate management are essential to prevent complications and improve clinical outcomes.

Faridpur Med. Coll. J. 2025;21(2): 65-68