Clinical features

With milder expressions of the syndrome, the clinical manifestations are subtle. At the other extreme more overt expressions of acute hypocalcaemia may be present:

• increased neuromuscular excitability:
  • may cause Chvostek's sign, tetany, carpopedal spasms, laryngeal stridor and convulsions
    
    
• mental changes - ranging from irritability to depression and frank psychosis
  
  
• neurological signs suggesting an intracranial tumour with elevated CSF pressure e.g. papilloedema
  
  
• intracranial calcification visualised by skull radiology - particularly, in the basal ganglia
  
  
• calcification of lens, leading to formation of cataracts
  
  
• abnormalities of cardiac conduction - mainly prolonged Q-T intervals and T-wave changes
  
  
• abnormalities of dentition with defective enamel, dental hypoplasia, and delayed eruption of teeth
  
  
• alopecia with premature greying
  
  
• chronic mucocutaneous candidiasis is common in autoimmune hypoparathyroidism