CO19 | Calcium addicted room-mates: malabsorption of calcium and levothyroxine in SIBO, a case report
Year: 2025
Type: article
Study design: Case Report
Abstract: Premises: Small intestinal bacteria overgrowth (SIBO) is a condition characterized by an high count of bacteria in the small bowel. Several situations predispose to SIBO, such as motility and anatomical disorders, immunodeficiencies and others. Typical clinical presentation is characterized by diarrhea, bloating, and malabsorption.Description of the Case report: An 82-years-old woman came to our emergency department complaining limbs paresthesia. Around forty years ago she underwent a total thyroidectomy for multinodular struma that lead to hypothyroidism and hypoparathyroidism. She also referred an IgA deficiency and a long story of unexplained anemia. She assumed high doses of thyroid hormones (2 mcg/kg/die), calcium (6 g/die), calcitriol (1 mcg/die), and cholecalciferol (800 UI/die). Despite this therapy blood exams showed persistent severe hypocalcemia. Celiac disease, atrophic autoimmune gastritis, and Helicobacter Pylori infection were excluded. A glucose breath test allowed a diagnosis of SIBO and the patient was treated with rifaximin 1200 mg/die. After therapy there was a rapid increased in calcium and thyroid hormones levels and she was discharged with 2g/die of calcium, 0.25 mcg/die of calcitriol and 1.4 mcg/kg/die of levothyroxin. Conclusions: Epidemiology and physiopathology in SIBO are not yet completely known. In some conditions, like IgA deficiency, there is an higher risk for this disorder. Patients with risk factors complaining of gastrointestinal symptoms and/or sign of malabsorption must be investigated for SIBO and treated with specific therapy.
Source: Italian Journal of Medicine
Authors: Vo Van Kha, Tran Thi Huong Ly, Pham Thi Thanh Hoa, Vo Huynh Nhu, Damas Hendriansyah, Nusratuddin Abdullah, Rudy B. Leonardy, Mardiah Tahir, Samrichard Rambulangi, Firdaus Hamid, Filomena Pietrantonio, Vera Kopsaj, Francesco Rosiello, Aurora Tomassoni, Luca Moriconi, Donatella Padua, Kiki Rizki Amelia, Efendi Lukas, Nurbani Bangsawan, Isharyah Sunarno, Retno Budiarti Farid, Sriwijaya Qadar, Rabab H. Elshaikh, Ashok Kumar Sah, Abdelrahman Mohamed Abukanna, Abdulrahman Algarni, Ammar Abdelmola, Hussam Ali Osman, Tagwa Yousif Elsayed Yousif, Elryah I. Ali, Hiba Ali, Ayman Hussein Alfeel, Thanh Long Nguyen, Victor Storm, Lam Toi Phung, Cong Thien Le, Thi Thu Ha Le, Thi Hoa Nguyen, Son Tung Vu, Thien Thang Tran, Minh Hanh Vu, Van Tuan Nguyen, Francesco Ventrella, Anna Belfiore, Antonio Greco, Franco Mastroianni, Salvatore Lenti, Domenico Ruggiero, Michele Cannone, Vincenzo Ostilio Palmieri, Massimo Errico, Giuseppe Mancia, Guido Grassi, Sverre E. Kjeldsen
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413772336