Volume 182 - Issue 3
Neurological sequelae of chronic profound hypocalcaemia
Authors: Huong Van Nguyen and Seng Khee Gan
Med J Aust 2005; 182 (3): 123. || doi: 10.5694/j.1326-5377.2005.tb06614.x
Published online: 7 February 2005
Published online: 7 February 2005
A 66-year-old man presented with a 12-month history of progressive gait disturbance with cerebellar ataxia and extrapyramidal features. Computed tomography of the head showed calcification of the basal ganglia and dentate nuclei of the cerebellum, and periventricular calcification (Box).
Biochemical testing showed serum level of calcium, 1.19 mmol/L (reference range [RR], 2.15–2.55 mmol/L); ionised calcium, 0.61 mmol/L (RR, 1.14–1.29 mmol/L); phosphate, 1.8 mmol/L (RR, 0.8–1.5 mmol/L); and parathyroid hormone, 0.9 pmol/L (RR, 1.5–8.0 pmol/L). The patient was diagnosed with hypocalcaemia caused by idiopathic hypoparathyroidism. He was treated with calcitriol (2 μg daily) and calcium carbonate (6.0 g daily). His gait showed some improvement, and serum calcium levels became normal over several weeks.
The pathophysiology of intracerebral calcification in hypoparathyroidism, which appears paradoxical, is unknown. It is usually asymptomatic. When neurological effects occur, they are thought to be caused by microvascular degeneration from massive perivascular calcium deposition in high-metabolic areas.
When ‘Liver Enzymes’ Are Not Hepatic: Late-Onset Pompe Disease
Shauna Madigan, Georgina England, Wayne Rankin
Primary Hyperparathyroidism in Adults: Recent Developments in Diagnosis and Management
Elizabeth Wootton, Sunita M. C. De Sousa, Richard L. Prince, Donald S. A. McLeod, David A. Pattison, Mathis Grossmann
Severe Hypoglycaemia Secondary to Chronic Opioid-Induced Hypothalamic–Pituitary–Adrenal Axis Suppression: An Under-Recognised Phenomenon
Michael Do, Annabelle Hayes, Malgorzata Brzozowska
Rethinking diabetes care for Indigenous Australians: the need for Indigenous‐codesigned and led diabetes models of care
Natalie Nanayakkara, Sharon Atkinson‐Briggs, Alicia J Jenkins, Neale D Cohen
The first Australian evidence‐based guidelines on male infertility
Darren J Katz, Liza O’Donnell, Robert I McLachlan, Tim J Moss, Clare V Boothroyd, Veena Jayadev, Sarah R Catford