Multiple Intracranial Calcifications and Spinal Compressions: Rare Complications of Type La Pseudohypoparathyroidism

Overview

Journal J Endocrinol Invest

Publisher Springer

Specialty Endocrinology

Date 2005 Oct 13

PMID 16218049

Citations 3

Authors

F Tseng

D Su

H Chen

K Tsai

Affiliations

Soon will be listed here.

Abstract

Type la pseudohypoparathyroidism (PHP la) is an unusual inherited disease. PHP la often causes extraskeletal calcifications and even soft tissue ossifications. Patients may present neurologic symptoms and signs related to hypocalcemia and hyperphosphatemia. We report here a 38-yr-old woman with PHP la who had two uncommon neurologic complications. One was involuntary movements related to basal ganglia calcification, and the other was myelopathy owing to ossifications of the posterior longitudinal ligament and multiple herniated intervertebral disks. Aggressive body weight control and corrections of hypocalcemia, hyperphosphatemia, and elevated PTH may be important to prevent these unusual neurologic complications. Regular and careful neurologic examinations should be performed for early diagnosis and treatments of these spinal lesions.

Citing Articles

Genetics of Diffuse Idiopathic Skeletal Hyperostosis and Ossification of the Spinal Ligaments.

Kato H, Braddock D, Ito N Curr Osteoporos Rep. 2023; 21(5):552-566.

PMID: 37530996 PMC: 10543536. DOI: 10.1007/s11914-023-00814-6.

Lower Leg Arterial Calcifications Assessed by High-Resolution Peripheral Quantitative Computed Tomography in Hypoparathyroid and Pseudohypoparathyroid Patients.

Vind Nielsen C, Underbjerg L, Grove-Laugesen D, Sikjaer T, Rejnmark L Calcif Tissue Int. 2021; 108(6):775-784.

PMID: 33576839 DOI: 10.1007/s00223-021-00814-7.

Nonclassic features of pseudohypoparathyroidism type 1A.

Shoemaker A, Juppner H Curr Opin Endocrinol Diabetes Obes. 2016; 24(1):33-38.

PMID: 27875418 PMC: 5484400. DOI: 10.1097/MED.0000000000000306.

References

Pearson D, Durward W, Fogelman I, Boyle I, Beastall G . Pseudohypoparathyroidism presenting as severe Parkinsonism. Postgrad Med J. 1981; 57(669):445-7. PMC: 2424956. DOI: 10.1136/pgmj.57.669.445. View

Okazaki T, Takuwa Y, Yamamoto M, Matsumoto T, Igarashi T, Kurokawa T . Ossification of the paravertebral ligaments: a frequent complication of hypoparathyroidism. Metabolism. 1984; 33(8):710-3. DOI: 10.1016/0026-0495(84)90209-9. View

Cavallo A, Meyer 3rd W, Bodensteiner J, CHESSON A . Spinal cord compression: an unusual manifestation of pseudohypoparathyroidism. Am J Dis Child. 1980; 134(7):706-7. DOI: 10.1001/archpedi.1980.02130190072020. View

Spiegel A . Mutations in G proteins and G protein-coupled receptors in endocrine disease. J Clin Endocrinol Metab. 1996; 81(7):2434-42. DOI: 10.1210/jcem.81.7.8675557. View

Firooznia H, Golimbu C, Rafii M . Case report 312. Diagnosis: progressive paraparesis in a woman with pseudohypoparathyroidism (PHP) with ossification of the posterior longitudinal ligament from C4 to T5. Skeletal Radiol. 1985; 13(4):310-3. DOI: 10.1007/BF00355355. View

Muenter M, Whisnant J . Basal ganglia calcification, hypoparathyroidism, and extrapyramidal motor manifestations. Neurology. 1968; 18(11):1075-83. DOI: 10.1212/wnl.18.11.1075. View

Walters R . Idiopathic hypoparathyroidism with extrapyramidal and myopathic features. Arch Dis Child. 1979; 54(3):236-8. PMC: 1545234. DOI: 10.1136/adc.54.3.236. View

Okada K, Iida K, Sakusabe N, Saitoh H, Abe E, Sato K . Pseudohypoparathyroidism-associated spinal stenosis. Spine (Phila Pa 1976). 1994; 19(10):1186-9. DOI: 10.1097/00007632-199405001-00019. View

Cullen D, Pearce J . SPINAL CORD COMPRESSION IN PSEUDOHYPOPARATHYROIDISM. J Neurol Neurosurg Psychiatry. 1964; 27:459-62. PMC: 495776. DOI: 10.1136/jnnp.27.5.459. View

10.

Li K . Myelopathy caused by ossification of ligamentum flavum. Spine (Phila Pa 1976). 2002; 27(12):E308-12. DOI: 10.1097/00007632-200206150-00026. View

11.

Marguet C, Mallet E, Basuyau J, Martin D, Leroy M, Brunelle P . Clinical and biological heterogeneity in pseudohypoparathyroidism syndrome. Results of a multicenter study. Horm Res. 1997; 48(3):120-30. DOI: 10.1159/000185501. View

12.

Goadsby P, Lollin Y, Kocen R . Pseudopseudohypoparathyroidism and spinal cord compression. J Neurol Neurosurg Psychiatry. 1991; 54(10):929-31. PMC: 1014582. DOI: 10.1136/jnnp.54.10.929. View

13.

Kowdley K, Coull B, Orwoll E . Cognitive impairment and intracranial calcification in chronic hypoparathyroidism. Am J Med Sci. 1999; 317(5):273-7. DOI: 10.1097/00000441-199905000-00001. View

14.

Tsai C, Liu H, Chen H . Ossification of the posterior longitudinal ligament of the spine in Chinese. Taiwan Yi Xue Hui Za Zhi. 1978; 77(9):678-84. View

15.

Illum F, Dupont E . Prevalences of CT-detected calcification in the basal ganglia in idiopathic hypoparathyroidism and pseudohypoparathyroidism. Neuroradiology. 1985; 27(1):32-7. DOI: 10.1007/BF00342514. View

16.

Yamamoto Y, Noto Y, Saito M, Ichizen H, Kida H . Spinal cord compression by heterotopic ossification associated with pseudohypoparathyroidism. J Int Med Res. 1998; 25(6):364-8. DOI: 10.1177/030006059702500607. View

17.

Alam S, Kelly W . Spinal cord compression associated with pseudohypoparathyroidism. J R Soc Med. 1990; 83(1):50-1. PMC: 1292469. DOI: 10.1177/014107689008300121. View

18.

Evans B, Donley D . Pseudohypoparathyroidism, parkinsonism syndrome, with no basal ganglia calcification. J Neurol Neurosurg Psychiatry. 1988; 51(5):709-13. PMC: 1033082. DOI: 10.1136/jnnp.51.5.709. View

19.

Iwase T, Nokura K, Mizuno T, Inagaki T . Spastic tetraparesis in a patient with pseudopseudohypoparathyroidism. J Neurol. 2003; 249(10):1457-8. DOI: 10.1007/s00415-002-0822-1. View

20.

Kanda T, Nagashima T, Oda M, Hirose K, Tanabe H . Pseudopseudohypoparathyroidism with recurrent polyneuropathy: an autopsy report with special reference to the peripheral nervous system. J Neurol Sci. 1991; 103(1):42-7. DOI: 10.1016/0022-510x(91)90281-b. View