Welcome to Open Science
Contact Us
Home Books Journals Submission Open Science Join Us News
Diffuse Visceral Calcifications in Iatrogenic Hypoparathyroidism
Current Issue
Volume 3, 2015
Issue 3 (June)
Pages: 103-106   |   Vol. 3, No. 3, June 2015   |   Follow on         
Paper in PDF Downloads: 17   Since Aug. 28, 2015 Views: 1539   Since Aug. 28, 2015
Authors
[1]
Bujar Cakani, District Hospital of Elbasan, Elbasan, Albania.
[2]
Aleks Qosja, District Hospital of Elbasan, Elbasan, Albania.
[3]
Ferdinand Xhelili, District Hospital of Elbasan, Elbasan, Albania.
[4]
Artur Zajmi, Hygeia Hospital Tirana, Tirana, Albania.
[5]
Gentian Vyshka, Faculty of Medicine, University of Medicine, Tirana, Albania.
Abstract
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.
Keywords
Calcifications, Parathyroid Glands, Granulomatous Inflammation, Iatrogenic Hypoparathyroidism, Calcified Foci
Reference
[1]
Levy RC, Hawkins H, Barsan WG. Radiology in emergency medicine. The C. V. Mosby Company, 1986; pp. 174, 210.
[2]
Davis RL, Robertson DM. Textbook of neuropathology, Second Edition. Williams & Wilkins, 1991; pp. 486-487.
[3]
Grassi C. Pneumologia. In: Progressi in Medicina Interna (Edited by Carlo Zanussi). UTET, 1990; pp. 351-352.
[4]
Gawne-Cain ML, Hansell DM. The pattern and distribution of calcified mediastinal lymph nodes in sarcoidosis and tuberculosis: a CT study. Clin Radiol. 1996 Apr; 51(4):263-7.
[5]
Ahad MA, Bala CS, Karim SR. Fahr’s syndrome. Bang Med J (Khulna) 2012; 45:33-35.
[6]
Boulman N, Slobodin G, Rozenbaum M, Rosner I. Calcinosis in rheumatic diseases. Semin Arthritis Rheum. 2005 Jun; 34(6):805-12.
[7]
Gutierrez A Jr, Wetter DA. Calcinosis cutis in autoimmune connective tissue diseases. Dermatol Ther. 2012 Mar-Apr; 25(2):195-206.
[8]
Senanayake MP, Mettananda SG. Metastatic calcification: be watchful when renal failure complicates renal tubular acidosis. Sri Lanka Journal of Child Health. 2012; 41(3):148.
[9]
Rajab A, Aldinger KA, El-Shirbini HA, Dobyns WB, Ross ME. Recessive developmental delay, small stature, microcephaly and brain calcifications with locus on chromosome 2. Am J Med Genet A. 2009 Feb; 149A (2):129-37.
[10]
Basak RC. A case report of Basal Ganglia calcification - a rare finding of hypoparathyroidism. Oman Med J. 2009 Jul; 24(3):220-2.
[11]
Senoglu M, Tuncel D, Orhan F, Yuksel Z, Gokçe M. Fahr’s syndrome: a report of two cases. Firat Tip Dergisi. 2007; 12(1):70-72.
[12]
Odubanjo MO, Abdulkareem FB, Banjo A, Ekwere TE, Awelimobor DI. Idiopathic pulmonary calcification and ossification in an elderly woman with a missed diagnosis of subarachnoid haemorrhage. Ghana Med J. 2013 Sep; 47(3):153-6.
[13]
Zerhouni S, Mayer C, Skarsgard ED. Can we select fetuses with intra-abdominal calcification for delivery in neonatal surgical centres? J Pediatr Surg. 2013 May; 48(5):946-50.
[14]
Langman G, Hall PD. Focal nodular hyperplasia with calcification and ossification. Pathology. 2001 Aug; 33(3):396-8.
[15]
Jain KA. Endometrioma with calcification simulating a dermoid on sonography. J Ultrasound Med. 2006 Sep; 25(9):1237-41.
[16]
Zhao Z, Xuan X, Zhang J, He J, Zeng G. A prospective study on association of prostatic calcifications with sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). J Sex Med. 2014 Oct; 11(10):2528-36.
[17]
Zisimopoulou V, Siatouni A, Tsoukalos G, Tavernarakis A, Gatzonis S. Extensive bilateral intracranial calcifications: a case of iatrogenic hypoparathyroidism. Case Rep Med. 2013; 2013:932184.
[18]
Gionanlis L, Vainas A, Bamihas G, Veneti P, Sobolos K. Brain calcinosis in a dialysis patient with hypoparathyroidism. Nephrology Dialysis Transplantation Plus. 2008; 1:36-40.
[19]
Wang SY, Wu W, Ma X. Recurrent seizures manifestations in a case of congenital hypoparathyroidism: a case report. Chin Med Sci J. 2013 Dec; 28(4):242-4.
[20]
Bilge I, Sadikoğlu B, Emre S, Sirin A, Tatli B. Brain calcification due to secondary hyperparathyroidism in a child with chronic renal failure. Turk J Pediatr. 2005 Jul-Sep; 47(3):287-90.
[21]
Mahmoodi M, De Sanctis V, Karimi M. Diffuse intracerebral calcification in a beta-thalassemia major patient with hypoparathyroidism: a case report. Pediatr Endocrinol Rev. 2011 Mar; 8 Suppl 2:331-3.
[22]
Pasch A, Schaffner T, Huynh-Do U, Frey BM, Frey FJ, Farese S. Sodium thiosulfate prevents vascular calcifications in uremic rats. Kidney Int. 2008 Dec; 74(11):1444-53.
[23]
Wada T, McKee MD, Steitz S, Giachelli CM. Calcification of vascular smooth muscle cell cultures: inhibition by osteopontin. Circ Res. 1999 Feb 5; 84(2):166-78.
Open Science Scholarly Journals
Open Science is a peer-reviewed platform, the journals of which cover a wide range of academic disciplines and serve the world's research and scholarly communities. Upon acceptance, Open Science Journals will be immediately and permanently free for everyone to read and download.
CONTACT US
Office Address:
228 Park Ave., S#45956, New York, NY 10003
Phone: +(001)(347)535 0661
E-mail:
LET'S GET IN TOUCH
Name
E-mail
Subject
Message
SEND MASSAGE
Copyright © 2013-, Open Science Publishers - All Rights Reserved