Calcificações cerebrais por hipoparatireoidismo: Considerações sobre o diagnóstico, longo tempo após a tireoidectomia

Abstract

The diagnosis of hypoparathyroidism with neurological findings occurring years after thyroid surgery is considered to be rare. The authors describe 3 cases of hypoparathyroidism associated to brain calcifications diagnosed many years after partial thyroidectomy. Two patients were admitted to Emergency Services presenting with seizures, without a previous diagnosis of hypoparathyroidism. The diagnosis was suspected adding the biochemical analysis to the scar on the neck. The CT, which was performed more than 20 years after surgery, showed large cerebral calcifications in both cases. The third patient did not have neurological symptoms, but presented basal and cerebelar calcifications that were demonstrated in the CT. All patients were treated with calcium and vitamin D with great improvement of clinical status. Adding to a case published previously, we count 4 cases from the same region. Thyroidectomies were very common in this region poor in dietary iodide. Since the clinical follow up was inadequate, we suspect that undetected cases similar to these may exist in the present moment.