Abe S, Tojo K, Ichida K, Shigematsu T, Hasegawa T, Morita M, Sakai O
Second Department of Internal Medicine, Jikei University School of Medicine, Tokyo.
Intern Med. 1996 Feb;35(2):129-34. doi: 10.2169/internalmedicine.35.129.
A 47-year-old man was admitted for evaluation of unsteady gait, postural instability, and dysarthria. On admission, neurological examinations revealed cerebellar ataxia, extrapyramidal signs including parkinsonism and positive Trousseau's sign. Laboratory findings revealed severe hypocalcemia and hyperphosphatemia, and serum intact parathyroid hormone was not detectable. Brain computed tomography revealed severe calcification of basal ganglia and dentate nuclei. He was diagnosed as idiopathic hypoparathyroidism; treatment with 1 alpha (OH) vitamin D3 brought marked improvement of neurological manifestations. We report a rare case of idiopathic hypoparathyroidism presenting with extrapyramidal and cerebellar dysfunction with a review of literature.
一名47岁男性因步态不稳、姿势性不稳和构音障碍入院评估。入院时,神经系统检查发现小脑共济失调、锥体外系体征(包括帕金森症)以及特鲁索氏征阳性。实验室检查结果显示严重低钙血症和高磷血症,血清完整甲状旁腺激素检测不到。脑部计算机断层扫描显示基底神经节和齿状核严重钙化。他被诊断为特发性甲状旁腺功能减退症;使用1α(OH)维生素D3治疗后,神经症状明显改善。我们报告一例罕见的特发性甲状旁腺功能减退症病例,该病例表现为锥体外系和小脑功能障碍,并对相关文献进行了综述。