Bilateral Basal Ganglia Calcification: Fahr's Disease

Fahr's syndrome, recently named "primary brain calcification," is a rare disorder with a variable clinical presentation ranging from behavioral changes to seizures. It can be idiopathic or have multiple causes, hypoparathyroidism the most frequent. In the current coronavirus 2019 (COVID-19) pandemic, these electrolyte imbalances have acquired importance, and there has been a correlation between the lowest serum calcium levels and severe COVID-19 disease. It is known that calcium accomplishes many normal physiologic functions.We present a case of a 63-year-old woman who arrived at the emergency room with a fever of 10-day duration, odynophagia, dry cough, dyspnea, and drowsiness. Upon her arrival, computed tomography of the brain and chest was performed, showing areas of calcification in the basal nuclei and infiltrates with a ground-glass pattern, respectively. In addition, laboratory studies were conducted in which hypocalcemia and hyperphosphatemia stand out. Furthermore, a positive result was obtained from acute Respiratory Syndrome Coronavirus 2 (SARS-COV2) from bronchial secretion. According to the clinical presentation data in the imaging and laboratory studies, Fahr's syndrome and COVID-19 pneumonia were diagnosed.We consider evaluating electrolyte imbalances at case presentations essential and continuously monitoring them. Appropriate and prompt corrections were achieved in patients with hypoparathyroidism history and severe COVID-19 disease. This case shows the vital collaboration between endocrinologists and other physicians that care for patients with COVID-19 infection.

Section: Discussionmentioning

confidence: 99%

“…Those present in an acute form may compromise the nervous and muscular systems. In contrast, those with a chronic condition may initiate a metabolic cascade that results in ectopic calcifications and ectopic calcium deposits in the brain, which may cause diverse neurological problems [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Fahr’s Syndrome for Primary Hypoparathyroidism in a Patient With COVID-19

Irisson-Mora¹,

Rodríguez-Hernández²,

Balcázar-Padrón³

et al. 2022

“…Baseline biochemical investigations may be done to rule out other possible diagnoses. Molecular genetic testing can be done if there is a strong history of autosomal dominant inheritance [11].…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Basal Ganglia Calcification: Fahr’s Syndrome, a Rare Disorder

Thillaigovindan

Arumugam

Rai

et al. 2019

Fahr’s syndrome is a rare neurological disorder with varied clinical manifestations. It is characterized by the progressive deposition of calcium in the walls of the blood vessels of basal ganglia and dentate nuclei of the cerebellum in young and middle-aged people. It is important for neurologists, geneticists, psychiatrists, dentists, and other appropriate care specialists to have a thorough knowledge of this syndrome as any of them could be the first person to diagnose the disease. This case report of Fahr’s syndrome presents the signs and symptoms of the patient and the treatment for oral conditions were done.

“…A computed tomography (CT) scan is a method of choice to diagnose calcifications in the dentate nuclei, corona radiata, thalami, and lentiform nuclei, while the non-calcified inflammatory processes are detected by magnetic resonance imaging (MRI) in the setting of Fahr’s disease [ 11 ]. In addition, the assessment of other associated conditions, including lipoid proteinosis, mitochondrial myopathy, tuberculous sclerosis, neuroferritinopathy, brucellosis infection, hyperparathyroidism, pseudo-hypothyroidism, secondary hypoparathyroidism, and idiopathic hypoparathyroidism is paramount to ruling out Fahr’s disease [ 12 ]. The treatment algorithms for Fahr’s disease aim to manage neuropsychiatric symptoms and their underlying etiologies [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 Infection on a Neurologically Compromised Male With Fahr’s Disease Presenting With Acute Delirium and Aspiration Pneumonia: A Case Report

Bhangal¹,

Sandhu²,

Umar³

et al. 2022

Fahr’s disease or idiopathic basal ganglia calcification is a rare, sporadic, genetically dominant, and inherited neurological condition that manifests with dysphagia and Parkinson’s disease. The computed tomography (CT) scan is the method of choice to diagnose basal ganglia calcifications seen in Fahr’s disease. This case report elaborates on the emergency management of a 58-year-old male patient with acute respiratory distress, acute delirium, schizophrenia, Fahr’s syndrome, and history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 or COVID-19) infection. The patient’s chest X-ray, laboratory workup, and vital signs were suggestive of aspiration pneumonia-induced sepsis and acute hypoxemic respiratory failure. Post-admission antibiotic management reduced sepsis complications without improving the altered mental status. A comprehensive clinical assessment suggested the attribution of Fahr’s disease to the patient’s aspiration pneumonia and other clinical complications. In addition, COVID-19 infection, sepsis-induced inflammatory processes, and pre-existing neurological compromise possibly deteriorated the patient’s neurological outcomes, overall prognosis, and recovery.