Hypoparathyroidism with situs inversus totalis: A case report

Table 1 Laboratory examinations

Item	WBC (× 109 /L)	α-HBD (U/L)	LDH (U/L)	CK-MB (U/L)	CK (U/L)	CREA (μmol/L)	LAC (mmol/L)	Ca (mmol/L)	Mg (mmol/L)	IP (mmol/L)
Result	12.4	290.4	449.4	45	774.8	60	7.32	1.28	0.72	1.31
Reference range	4–10	90–182	109–245	0–24	18–198	44–131	0.5–1.5	2.25–2.58	0.8–1.2	0.97–1.61

WBC: White blood cells; α-HBD: α-hydroxybutyrate dehydrogenase; LDH: Lactate dehydrogenase; CK-MB: Creatine kinase-MB; CREA: Creatinine; LAC: Lactate; Ca: Serum calcium; Mg: Serum magnesium; IP: Inorganic phosphate.

Table 2 Laboratory examination

Item	Na (mmol/L)	K (mmol/L)	Cl (mmol/L)	cTNT (μg/L)	PTH (pg/mL)	25(OH)D (nmol/L)	AST (U/L)	ALT (U/L)	TBIL (μmol/L)
Result	Normal	Normal	Normal	Normal	4.5	25	Normal	Normal	Normal
Reference range	135-145	3.5-5.5	96-108	< 0.1	12–88	75–250	0-40	5-40	3.4-17.1

Na: Serum sodium; K: Serum kalium; Cl: Serum chloride; cTNT: Troponin T; PTH: Parathyroid hormone; 25(OH)D: 25-hydroxyvitamin D; AST: Aspartate aminotransferase; ALT: Alanine transaminase; TBIL: Total bilirubin.

Table 3 Imaging examinations

Item	Result
Cranial computed tomography (Figure 1)	Multiple calcifications are found in bilateral cerebral hemispheres, cerebellar hemispheres and brainstem
Chest computed tomography (Figure 2, Figure 3, and Figure 4)	Total situs inversus, mirror - image dextrocardia, cardiac enlargement (mainly left ventricular enlargement) and a small amount of pericardial effusion are noted; Multiple patchy high - density shadows are seen in both lungs, indicating bilateral pulmonary inflammation; A small amount of pleural effusion is present on both sides
Doppler echocardiography	Dextrocardia, enlarged left atrium, decreased left ventricular systolic function, with an ejection fraction of 40%
Parathyroid ultrasound	No parathyroid glands visible on either side