A rare case of sever primary hypoparathyroidism presented with amnesia and basal ganglia calcification.

OBJECTIVES: The aim of this study was to describe clinical findings in a 45-year-old man with history of two sided cataract surgery, convulsions and progressive memory impairment. METHODS: The patient presented to the neurology department because of having progressive memory impairment over the past two years. After taking necessary examinations the patient was referred to the endocrine center because of hypocalcemia in laboratory tests. Brain CT scan and MRI was also done. RESULTS: Brain CT scan of patient showed extensive and symmetric calcification of basal ganglia, thalami and cerebellum. On Brain MRI, abnormal signal foci in the both sided paraventricular regions, basal ganglia and cerebellar hemisphere were depicted. Laboratory investigations were notable for low serum calcium (5.4 mg/dl, reference range: 8.2-11.2), high serum phosphorus (7.6 mg/dl, reference range: 2.7-4.5), vitamin D deficiency (25-OH D3: 14.5 ng/ml) and low parathyroid hormone (IPTH: 3.7 pg/mL, reference range: 10-62). CONCLUSIONS: This patient presented with amnesia which is a rare presentation of hypoparathyroidism.

Diagnostic Value of Neuron-Specific Enolase (NSE) and Cancer Antigen 15-3 (CA 15-3) in the Diagnosis of Pleural Effusions

Introduction: Pleural effusion diagnosis plays an important role in determining treatment strategies. The aim of this study was to determine the diagnostic capacity of tumor markers CA 15-3 and NSE solely or in combination in differentiating the nature of pleural fluid. Methods and Materials: In this cross-sectional study we evaluated 93 patients with pleural effusions (44 malignant and 49 benign). NSE and CA 15-3 serum and pleural levels were measured simultaneously using immunoenzyme assay kits. Diagnosis was established on the basis of cytological study. Results: Sensitivity and specificity of CA 15-3 serum and pleural level measurement were 70.4%, 49.0%, and 79.5% and 49.0%, respectively. Serum NSE levels had 75.0% sensitivity and 69.4% specificity while the respective pleural figures were 75.0% and 73.5%. The combination of NSE and CA 15-3 serum and pleural levels had the highest sensitivity (93.2%), although combined serum levels had the lowest sensitivity (47.7%). With an accuracy of 74.2%, pleural levels of NSE had the highest diagnostic potential. Conclusion: Measuring NSE and CA 15-3 tumor markers is a suitable approach to distinguish the nature of pleural effusions, with NSE pleural levels demonstrating the highest diagnostic accuracy.