Celiac disease and hypoparathyroidism may co-exist in the same patient. A patient with both conditions may develop abnormal serum calcium levels. Diagnosis can be a challenge if one or both of the conditions go unrecognized.


Causes of hypoparathyroidism may include:

(1) following thyroidectomy

(2) due to autoantibodies, which may or may not be associated with the celiac disease


Situations that can arise:

(1) A patient taking calcium and vitamin D supplements may develop hypercalcemia if a gluten-free diet is started and maintained.

(2) Hypocalcemia may develop if there is a worsening of the malabsorption, either due to progression of the celiac disease or occurrence of a second gastrointestinal disorder such as chronic diarrhea.

(3) Serum calcim levels may fluctuate if the patient varies in adherence to various the regimens.


Complications that may develop include:

(1) nephrocalcinosis or kidney stones

(2) metabolic bone disease

(3) renal failure


The serum calcium should be monitored if there is a change in the patient's condition. The frequency of monitoring can be decreased once the patient is stable.


A patient should have both anti-endomysial antibodies and parathyroid hormone levels measured if an unexplained change in calcium concentration occurs, especially if the patient has a history of a bowel disease.


To read more or access our algorithms and calculators, please log in or register.