Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2019; 7(21): 3662-3670
Published online Nov 6, 2019. doi: 10.12998/wjcc.v7.i21.3662
Hypoparathyroidism with Fahr’s syndrome: A case report and review of the literature
Yuan-Yuan Zhou, Ying Yang, Hong-Mei Qiu
Yuan-Yuan Zhou, Ying Yang, Department of Endocrinology and Metabolism, Fourth Affiliated Hospital of Kunming Medical University and The Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
Yuan-Yuan Zhou, Hong-Mei Qiu, Department of Endocrinology and Metabolism, Sixth Affiliated Hospital of Kunming Medical University and The People’s Hospital of Yuxi City, Yuxi 653100, Yunnan Province, China
Author contributions: Zhou YY was the patient’s endocrinologist, reviewed the literature ,and contributed to manuscript drafting; Yang Y was responsible for the revision of the manuscript for important intellectual content and final approval of the version of the article to be published; Qiu HM revised the manuscript ; all authors issued final approval for the version to be submitted.
Supported by Endocrine Clinical Medical Center of Yunnan Province, No. ZX2019-02-02; Endocrine Clinical Medical Center of Yunnan Province, No. ZX2019-02-02; Natural Science Foundation of China (No. 81760734; No. 31660313); Natural Science Foundation of Yunnan Province (No. 2017FA048; No. 2017FE467); the fund of Diabetic Innovation Team (No. 2019HC002); the fund of medical leader in Yunnan Province (No. L-201609).
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ying Yang, PhD, MD, Chief Doctor, Department of Endocrinology and Metabolism, Fourth Affiliated Hospital of Kunming Medical University and The Second People's Hospital of Yunnan Province, No. 176, Youth Road, Kunming 650021, Yunnan Province, China. yangying2072@126.com
Telephone: +86-13577751233
Received: April 16, 2019
Peer-review started: April 19, 2019
First decision: September 9, 2019
Revised: September 24, 2019
Accepted: October 5, 2019
Article in press: October 5, 2019
Published online: November 6, 2019
Processing time: 206 Days and 14 Hours
Abstract
BACKGROUND

Hypoparathyroidism with basal ganglia calcification is clinically rare. Here, we report a case of Fahr’s syndrome due to hypoparathyroidism and review the literature in terms of etiology, clinical manifestation, diagnosis, and treatment.

CASE SUMMARY

A 62-year-old man experienced repeated twitching of both hands in recent 10 years. On July 28, 2017, the patient was admitted to our hospital due to slow response and speech difficulties. On medical examinations, he had a positive Chvostek sign, while no Albright’s hereditary osteodystrophy signs or history of neck surgery or radiation, and his family members had no similar medical history. Laboratory examinations revealed hypocalcemia, hyperphosphatemia, and low parathyroid hormone (PTH) levels. Computed tomography revealed basal ganglia calcification. Based on these investigations, a diagnosis of Fahr’s syndrome due to hypoparathyroidism was suggested. After receiving intravenous calcium gluconate to relieve symptoms, the patient continued to take oral calcium carbonate and calcitriol for treatment.

CONCLUSION

The possibility of hypoparathyroidism should be considered in patients with chronic hypocalcemia, recurrent tetany, and even neuropsychiatric symptoms. Hypoparathyroidism is a common cause of basal ganglia calcification. Therefore, it is recommended that blood calcium, phosphorus, and PTH levels should be measured in all individuals with basal ganglia calcification to exclude hypoparathyroidism.

Keywords: Hypoparathyroidism; Hypocalcemia; Fahr’s syndrome; Case report

Core tip: The clinical manifestations of hypoparathyroidism are complex and varied. Fahr's syndrome is diagnosed when basal ganglia calcification occurs. Fahr's syndrome is clinically rare. Here, we report a case of Fahr’s syndrome due to hypoparathyroidism and review the literature from etiology, clinical manifestation, diagnosis, and treatment. On the one hand, this case reflects the importance of standardized treatment and follow-up in patients with hypoparathyroidism. On the other hand, it is recommended that clinicians first consider the possibility of hypoparathyroidism when looking for the cause of basal ganglia calcification.