Radiological Features of Long-Standing Hypoparathyroidism

Area of Science:

• Endocrinology
• Rare Diseases
• Skeletal Disorders

Background:

• Idiopathic hypoparathyroidism (IHP) is an extremely rare endocrine disorder affecting approximately 37 in 100,000 individuals.
• This case report details a 30-year-old male with an 8-year history of progressive muscle weakness, carpopedal spasms, and limited mobility.

Observation:

• The patient presented with severe hip pain, generalized muscle weakness, facial discomfort, carpopedal spasms, and abdominal pain.
• Clinical examination revealed Chvostek and Trousseau signs. Biochemical tests indicated hypocalcemia, hyperphosphatemia, hypomagnesemia, and low parathyroid hormone levels.
• Radiographic imaging showed spondylarthropathic changes and basal ganglia calcifications, indicative of long-standing IHP.

Findings:

• Treatment with intravenous calcium gluconate, magnesium, and oral vitamin D3 improved muscle weakness and spasms with near-normal biochemical parameters.
• However, symptoms related to spondyloarthropathy did not improve, highlighting the irreversible nature of these skeletal changes.
• Long-standing IHP can mimic ankylosing spondylitis and DISH, emphasizing the importance of considering endocrine causes in rheumatological presentations.

Implications:

• Early diagnosis and management of idiopathic hypoparathyroidism are essential to prevent irreversible skeletal complications.
• Untreated IHP poses risks of life-threatening conditions such as cardiac arrhythmias and broncholaryngospasm.
• Recognizing the diverse clinical manifestations of IHP is crucial for timely intervention and improved patient prognosis.