Skip to main content Skip to main navigation menu Skip to site footer

A patient with suspect of Fahr syndrome caused by secondary hypoparathyroid after total thyroidectomy

  • Putu Amanda Widiada ,
  • Made Ratna Saraswati ,

Abstract

Background: Hypoparathyroid is an endocrine disorder that is characterized by hypocalcemia and hyperphosphatemia due to insufficient secretion of parathyroid hormone. Mostly, this disease is secondary caused by neck surgery and it is responsible for almost all cases of hypoparathyroid. Parathyroid hormones responsibles for maintaining homeostasis of calcium. Fahr syndrome is a neurodegenerative disorder characterized by bilateral basal ganglia calcification that is caused by endocrine disorder such as hypoparathyroid.

Case Presentation: In this case report, we reported a 70 years old woman with secondary hypoparathyroidism presenting with Fahr's syndrome after total thyroidectomy. Besides hypocalcemia and hyperphosphatemia as signs of secondary hypoparathyroidism, specific clinical signs with Fahr's syndrome in this case is presence of multiple calcifications in several parts of the brain and specifically in the bilateral of basal ganglia. Management of this disease mainly focused on supplementation of calcium and vitamin D.

Conclusion: Fahr syndrome is a rare, genetically dominant, inherited neurological disorder that should be considered as the main problem in several patients with post total thyroidectomy.

Section

References

  1. Al-Azem H, Khan AA. Hypoparathyroidism. Best Pract Res Clin Endocrinol Metab. 2012;26:517–522.
  2. Bollerslev J, Rejnmark L, Marcocci C, Shoback DM, Sitges-Serra A, van Biesen W, Dekkers OM; European Society of Endocrinology. European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol. 2015;173(2):G1-20.
  3. Zhou YY, Yang Y, Qiu HM. Hypoparathyroidism with Fahr’s syndrome: A case report and review of the literature. World J Clin Cases. 2019;7:3662–3670.
  4. Ritter K, Elfenbein D, Schneider DF, Chen H, Sippel RS. Hypoparathyroidism after total thyroidectomy: incidence and resolution. J Surg Res. 2015;197:348–353.
  5. Cooper MS, Gittoes NJL. Diagnosis and management of hypocalcaemia. BMJ. 2008;336:1298–1302.
  6. Albuja-Cruz MB, Pozdeyev N, Robbins S, Chandramouli R, Raeburn CD, Klopper J, Haugen BR, McIntyre R Jr. A "safe and effective" protocol for management of post-thyroidectomy hypocalcemia. Am J Surg. 2015 Dec;210(6):1162-8.
  7. Rejnmark L, Sikjaer T, Underbjerg L, Mosekilde L. PTH replacement therapy of hypoparathyroidism. Osteoporos Int. 2013;24:1529–1536.
  8. Marinkovic D, Dragovic T, Kikovic S, Jankovic SK, Djuran Z, Hajdukovic Z. Fahr’s syndrome and idiopathic hypoparathyroidism: A case report. Vojnosanit Pregl. 2017;74:184–188.
  9. Goswami R, Sharma R, Sreenivas V, Gupta N, Ganapathy A, Das S. Prevalence and progression of basal ganglia calcification and its pathogenic mechanism in patients with idiopathic hypoparathyroidism. Clin Endocrinol (Oxf). 2012;77(2):200-6.
  10. Yolanda AM, Adnyana IMO, Widyadharma IPE, Sudiariani NKA. Case Report: Fahr’s Syndrome on Post Thyroidectomy Patient. Int J Med Rev Case Rep. 2020;4(11):87-9.
  11. Saleem S, Aslam HM, Anwar M, Anwar S, Saleem M, Saleem A, Rehmani MA. Fahr's syndrome: literature review of current evidence. Orphanet J Rare Dis. 2013;8:156.
  12. Bilezikian JP, Brandi ML, Cusano NE, Mannstadt M, Rejnmark L, Rizzoli R, Rubin MR, Winer KK, Liberman UA, Potts JT Jr. Management of Hypoparathyroidism: Present and Future. J Clin Endocrinol Metab. 2016;101(6):2313-24.

How to Cite

Widiada, P. A., & Saraswati, M. R. (2023). A patient with suspect of Fahr syndrome caused by secondary hypoparathyroid after total thyroidectomy. Indonesia Journal of Biomedical Science, 17(2), 295–299. https://doi.org/10.15562/ijbs.v17i2.516

HTML
24

Total
29

Share

Search Panel

Putu Amanda Widiada
Google Scholar
Pubmed
IJBS Journal


Made Ratna Saraswati
Google Scholar
Pubmed
IJBS Journal