Diffuse Visceral Calcifications in Iatrogenic Hypoparathyroidism
Introduction: Diffuse parenchymal calcifications generally are confined to one organ; when multi-organic, the clinical picture might be challenging. Deep disturbances in the calcium-controlling hormonal structures have been imputed, with hypoparathyroidism being one of those. Case Report: We describe the radiological characteristics of diffuse visceral calcifications detected in an Albanian woman aged 66 years, and admitted following recurrent seizures. Calcified foci were found bilaterally in the cerebral hemispheres, white matter and cerebellar structures, raising the suspicion of a Fahr syndrome. However, plain thoracic radiography and abdominal ultrasonography showed diffuse parenchymal calcifications even in the lung and kidneys. The picture of an iatrogenic hypoparathyroidism with tissue calcifications is rarely seen; when it presents patients do have some thyroid and parathyroid glands disorder. In our case, a thyroidectomy was performed eight years before the seizures’ occurrence. The level of PTH was half of the lower normal limit, suggesting the surgical removal of parathyroid glands being the cause of an apparent hypoparathyroidism. Conclusions: Endocrine control of calcium homeostasis is highly sophisticated, but rather delicate. Visceral calcifications have a numerous differential diagnosis that needs to be made in collaboration between the radiologist and the treating clinician. Ad hoc therapies and symptomatic treatment are available; in our case the treatment with antiepileptics controlled swiftly the frequency of the seizures.
Calcifications, Parathyroid Glands, Granulomatous Inflammation, Iatrogenic Hypoparathyroidism, Calcified Foci
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