Hypoparathyroidism presenting with seizures and intracranial calcifications in a child

Seizures and Basal Ganglia Calcification Caused by Hypoparathyroidism

“…The most common sites of calcification are the basal ganglia, as was the case in our patient, but calcification may also affect frontal cortex, thalamus, and cerebellum [7]. BCG in pediatric age group is pathological and may be seen in various pathologies, including endocrine disorders, congenital disorders, metabolic disorders, infections, and toxic conditions; however, hypoparathyroidism is the most common treatable cause [5].…”

“…Hypocalcemia, hyperphosphatemia, and low or inappropriately normal PTH levels characterize hypoparathyroidism, all the features being fulfilled by our patient. Patients with hypoparathyroidism present variably and may complain of fatigue, muscle cramps, twitching, bronchospasm, confusion, seizures, and congestive heart failure [5][6][7]. Our patient's complaint was consistent with muscle spasms, twitching, and seizures.…”

“…Hypoparathyroidism primarily develops due to ineffective production or secretion of PTH and defects in the PTH receptor [7]. The causes of hypoparathyroidism include congenital disorders, receptor insensitivity, surgery, autoimmune disorders, radiation, infiltrative disorders, or it can be idiopathic [5,6]. Idiopathic hypoparathyroidism is diagnosed after ruling out all secondary causes [7].…”

“…Calcium and active vitamin D supplementation are recommended therapy for hypoparathyroidism and similar were prescribed to our patient [5][6][7][8]. Patients with hypoparathyroidism should be followed up clinically, and laboratory investigations should be ordered as clinically indicated to monitor the course of disease and register any abnormalities [7].…”

“…If hypoparathyroidism is left undiagnosed or untreated, it can lead to multiple consequences, including renal disease, intracranial calcifications, seizures, neuropsychiatric disease, and cataracts [4]. Hence, it should be ruled out by investigating serum levels of calcium, phosphate, and parathyroid hormone (PTH) [5]. Hypoparathyroidism is characterized by hypocalcemia, hyperphosphatemia, and low or inappropriately normal levels of PTH [6].…”