Cerebral calcification from Fahr’s disease with co-existing haemochromatosis

old man was referred to M o r r i s t o n Hospital in S e p t e m b e r 2012 with slurred speech and a two-week history of progressively reduced mobility. The man had been found in bed by his carers, unable to mobilise. In 1996 he was diagnosed with haemochromatosis, which had been treated with repeated venesection. He was diagnosed with Parkinson’s disease in 2002; however, this diagnosis was changed to Parkinsonism in 2008 following a failure of response to dopaminergic medications and the finding of basal ganglia changes on MRI thought to be caused by iron deposition. He was also being followed up for a benign pituitary macroadenoma, diagnosed in 2007, treated with radiotherapy in 2009. Other conditions included chronic kidney disease stage 4 and right lower motor neuron facial weakness for which he had recently undergone tarsorrhaphy. His medication comprised: levothyroxine 50mcg once daily; furosemide 40mg once daily; 1-alpha-hydroxycholecalciferol 0.5mcg once daily; hydrocortisone 10mg twice daily; and aspirin 75mg once daily. Case notes z Fahr’s disease