The Marabou Feather Wing Sign
January 26, 2026
Letter to the editor: The “Marabou-feather wing” sign in hypoparathyroidism Daphne J. Theodorou1 · Stavroula J. Theodorou2 · Adamantios P. Petsanas3
Hypoparathyroidism is an endocrine-deficient disorder characterized by an absence or elimination of parathyroid hormone (PTH) and a derangement of the calcium homeostasis causing hypocalcemia. The condition can be inherited or acquired, with thyroidectomy comprising the second most common etiology of PTH deficiency in adults [1]. In PTH-deficient hypoparathyroidism, hypocalcemia coupled with hyperphosphatemia is responsible (among other manifestations) for the ectopic deposition of insoluble calcium phosphate complexes in the brain. Awareness of the neurological manifestations of hypoparathyroidism affecting the basal ganglia is important because abnormalities can be associated with serious morbidity and significant socioeconomic costs [1]. Awareness of hypoparathyroidism also is important because such awareness facilitates differentiation from other entities that can produce similar radiologic findings but have very different treatments and prognoses, such as Fahr’s disease, pseudohypoparathyroidism, primary hyperparathyroidism, hyperthyroidism, pure Parkinsonism, and dementia. We report our observations in secondary hypoparathyroidism featuring MR imaging changes in the basal ganglia that resemble the appearances of the Marabou bird fine feathered wings, for which we have coined the “Marabou-feather wing” sign. This association suggests this sign can be a clue to the diagnosis of PTH-deficient hypoparathyroidism associated with dysregulation of calcium homeostasis and cerebral changes.
FULL ARTICLE HERE FFeather Wing ARTICLE