Diffuse Symmetric Intracranial Calcification in Patients Diagnosed with Idiopathic Hypoparathyroidism: A Case Report

Abstract

Idiopatic hypoparathyroidism, is an important cause of basal ganglia calcification. Extensive calcification may also be seen at different intracranial locations such as thalamus, frontal white matter and cerebellum. In some studies it has been revealed that the duration of hypocalcemia has a positive corelation with intracranial calcification. The clinical significance of basal ganglia calcification in idiopatic hypoparathyroidism is not clear but has been linked to neuropsychological and neurological dysfunctions such as impaired attention, memory, defisit of information processing, executive function and extrapyramidal symptoms. Idiopatic hypoparathyroidism is a rare disease and there is insufficient data in the literature on the frequency of neuropsychological dysfunctions which may be seen in the disease. In this paper, a 49-year-old female patient which was admitted to hospital with complaints of numbness and spasm in the hands is presented. The clinical and imaging findings of the patient diagnosed with idiopatic hypoparathyroidism due to low calcium and parathormone levels in the laboratory examinations are discussed here. It is emphasized here that idiopathic hypoparathyroidy should also be considered in the differential diagnosis of extensive and symmetrical intracranial calcifications detected by the imaging methods such as computed tomography.

Keywords

• Idiopathic hypoparathyroidism,intracranial calcification,hypocalcemia

İDİOPATİK HİPOPARATİROİDZM TANILI HASTADA YAYGIN SİMETRİK İNTRAKRANİAL KALSİFİKASYONLAR: OLGU SUNUMU

Abstract

İdiopatik hipoparatiroidizm bazal ganglion kalsifikasyonunun önemli bir nedenidir. Talamus, frontal beyaz cevher ve serebellum gibi farklı intrakranial lokalizasyonlarda da yaygın kalsifikasyon izlenebilir.  Bazı çalışmalarda hipokalseminin süresi ile intrakranial kalsifikasyon arasında pozitif bir korelasyon olduğu gösterilmiştir. İdiopatik hipoparatiroidizmde izlenebilen bazal ganglion kalsifikasyonlarının klinik önemi çok net olmamakla beraber dikkat eksikliği, hafıza bozukluğu, bilgi işleme sürecinde defisitler, yürütücü işlevlerde bozulma ve ekstrapiramidal sistem semptomları gibi nöropsikiyatrik ve nörolojik disfonsiyon belirtileri ile ilişkilendirilmiştir. İdiopatik hipoparatiroidizm,  nadir bir hastalık olup literatürde bu hastalıkta izlenebilen nöropsikiyatrik disfonksiyonun sıklığına dair veriler yetersizdir.  Bu yazıda ellerde kasılma ve uyuşma şikâyeti ile hastaneye başvuran 49 yaşında bir bayan hasta olgu olarak sunulmaktadır. Bu olgu üzerinden, yapılan laboratuar incelemesinde düşük serum kalsiyum ve Parathormon seviyelerine sahip olması nedeni ile idiopatik hipoparatiroidizm tanısı alan hastanın, klinik ve görüntüleme bulguları tartışılacaktır. Bilgisayarlı tomografi gibi görüntüleme yöntemlerinde saptanan yaygın ve simetrik intrakranial kalsifikasyonların ayırıcı tanısında idiopatik hipoparatiroidinin de göz önünde bulundurulması gerekmektedir.  

Keywords

• : İdiopatik hipoparatiroidizm,intrakranial kalsifikasyon,hipokalsemi

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