Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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April 30, 2012 (CASE 1)
Dystrophic Calcification of Secondary Hyperparathyroidism
- Dystrophic calcifications of secondary hyperparathyroidism are typically seen in the basal ganglia, the thalami, periventricular white matter, cerebellum, and sometimes the cortex.
- The cause of the deposition is not entirely known. It may be the result of a slow inflammatory process resulting in calcification of the vessels and parenchyma, or direct leakage and deposition of calcium from the vasculature.
- Most patients are asymptomatic. However, features of parkinsonism, ataxia, or cognitive/psychiatric disturbances can occur.
- Key Diagnostic Features: Bilateral (usually symmetric) calcification within the basal ganglia, periventricular white matter, and cerebellum (often the dentate nuclei). In addition, such bilateral symmetric calcification can sometimes be seen within the thalami and the cortex.
- Hyperparathyroidism, hypoparathyroidism, pseudohypoparathyroidism, Fahr's disease, Cockayne's syndrome, Aicardi-Goutieres syndrome, normal aging.
- Aysmptomatic, hence no Rx. Recommend: Rx primary condition and supportive care.
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