Adult multisystem Langerhans cell histiocytosis involving parathyroid glands and pancreas

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To the editor:A 44-year-old Chinese man presented with an 8-year history of central diabetes insipidus and 3-month history of edema in both lower extremities was referred to our department.He developed fever and coughed with sputum after admission.His laboratory tests showed persistent low level of serum calcium (1.78-1.91 mmol/L) and parathyroid hormone (PTH) (10.55 ng/L),indicating hypoparathyroidism.Triiodothyronine (T3) and tetraiodothyronine (T4) were below normal (2.62 and 11.43 pmol/L,respectively),but thyroid-stimulating hormone (TSH) was within normal range (2.69 mIU/L),thus we considered the possibility of secondary hypothyroidism.
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