Hypoparathyroidism with Cartwheel-like Change in Thoracic Vertebral Body

Hiroka Matsuda¹, Kei Jitsuiki¹, Ken-ichi Muramatsu¹, Hiroki Nagasawa¹, Ikuto Takeuchi¹ and Youichi Yanagawa^1,

¹Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni, Japan

Cite this paper:
Hiroka Matsuda, Kei Jitsuiki, Ken-ichi Muramatsu, Hiroki Nagasawa, Ikuto Takeuchi and Youichi Yanagawa. Hypoparathyroidism with Cartwheel-like Change in Thoracic Vertebral Body. American Journal of Medical Case Reports. 2021; 9(8):386-388. doi: 10.12691/ajmcr-9-8-1

Abstract

A 34-year-old man was transported by ambulance to our hospital after experiencing generalized convulsions. He had been of short stature since birth, and had been diagnosed with growth hormone deficiency, which was treated with growth hormone therapy from 10 to 14 years of age. He experienced convulsions two times at 32 and 33 years of age, respectively, with spontaneous recovery. He had no specific family history. On arrival, he had clear consciousness and sinus tachycardia. A physical examination revealed short stature. A biochemical analysis of venous blood revealed hypocalcemia and a low level of parathyroid hormone. Head computed tomography (CT) revealed diffuse hyperostosis of the cranial vault and truncal CT revealed cartwheel apperance in the thoracic vertebral bodies from Th9 to Th12. He was treated with levetiracetam, alfacalcidol and calcium agents. Next-generation sequencing suggested heterozygous large deletion of T-box transcription factor (TBX1) gene. This is the first report of hypoparathyroidism with cartwheel-like change in the thoracic vertebral body. The further accumulation of cases is necessary to determine whether this change is specific to hypoparathyroidism.

Keywords:
convulsion hypocalcemia skull hyperostosis computed tomography

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