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

Yıl 2016, , 28 - 32, 30.04.2016

Mehmet Fatih Erbay

https://doi.org/10.24938/kutfd.252669

Cited By: 1

Öz

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.

Anahtar Kelimeler

Idiopathic hypoparathyroidism, intracranial calcification, hypocalcemia

İDİOPATİK HİPOPARATİROİDZM TANILI HASTADA YAYGIN SİMETRİK İNTRAKRANİAL KALSİFİKASYONLAR: OLGU SUNUMU

Öz

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.  

Anahtar Kelimeler

: İdiopatik hipoparatiroidizm, intrakranial kalsifikasyon, hipokalsemi

Kaynakça

• 1. Stelmasiak Z, Tarach JS, Nowicka-Tarach BM, Mitosek-Szewczyk K, Drop A. Idiopathic hypoparathyroidism with intracranial calcifications and dominant skin manifestations. Med Sci Monit. 2000; 6(1): 145-50.
• 2. Nora DB, Fricke D, Becker J, Gomes I. Hypocalcemic myopathy without tetany due to idiopathic hypoparathyroidism. Arq Neuropsiquiatr. 2004; 62(1): 154-7.
• 3. Thakker RV, Bringhurst FR, Juppner H. Calcium regulation, calcium homeostasis and genetic disorders of calcium metabolism. In: Jameson JL, DeGroot LJ, eds. Endocrinology. 6th ed. Philadelphia: Saunders; 2010: 1148.
• 4. Burtis WJ, Broadus AE. Hypercalcemia and hypocalcemia. In: Kelly WN, eds. Textbook of Internal Medicine. Philadelphia: JB Lippincot Company; 1989: 2246-52.
• 5. Fitzpatrik LA, Arnold A. Hypoparathyroidism. In: DeGroot LJ, eds. Endocrinology. 3 th ed. Philadelphia: WB Saunders Company. 1995: 1123- 35.
• 6. Aggarwal S, Kailash S, Sagar R, et al. Neuropsychological dysfunction in idiopathic hypoparathyroidism and its relationship with intracranial calcification and serum total calcium. European Journal of Endocrinology. 2013; 168(6): 895-903.
• 7. Girija AS. Idiopathic hypoparathyroidism with extensive intracranial calcification associated with kinesogenic choreoathetosis. J Assoc Physicians India. 2000; 48: 938-9.
• 8. Zisimopoulou V, Siatouni A, Tsoukalos G, Tavernarakis A, Gatzonis S. Extensive Bilateral Intracranial Calcifications: A Case of Iatrogenic Hypoparathyroidism. http://dx.doi.org/10.1155/2013/932184.
• 9. Karimi M, Habibzadeh F, De Sanctis V. Hypoparathyroidism with extensive intracerebral calcification in patients with 𝛽-thalassemia major. J Pediatr Endocrinol Metab. 2003; 16(6): 883-6.
• 10. Fukunaga M, Otsuka N, Ono S, et al. Computed tomography of basal ganglia calcifications in pseudo and idiopathic hypoparathyroidism. Radiat Med. 1987; 5(6): 187-90.
• 11. Friedman JH, Chiucchini I, Tucci JR. Idiopathic hypoparathyroidism with extensive brain calcification and persistent neurologic disfunction. Neurology. 1987; 37: 307-9.
• 12. Kline CA, Esekogwu VI, Henderson SO, Newton KI. Nonconvulsive status epilepticus in a patient with hypocalcemia. J Emerg Med. 1998; 16(5): 715-8.