Acute confusional state as the presenting feature of primary hyperparathyroidism

• Autor(a) principal: Ribeiro, João M.
• Data de Publicação: 2000
• Outros Autores: Lucas, Margarida, Vitorino, Rui M. M.
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/2011
• topic: hiperparatiroidismo primário; síndroma confusional; hipercalcemia; manifestações psiquiátricas; primary hyperparathyroidism; confusional states; hypercalcemia; psychiatric manifestations

Severe neuropsychological syndromes have beenpreviously described in association with primary hyperparathyroidism. The aetiopathogenic mechanisms underlying these rare neurological manifestations remain to be elucidated, as well as thebest therapeutic options, in such cases. We reportthe clinical case of a 68-year-old woman, who wasadmitted to the hospital because of an acuteconfusional state, in whom initial clinical investigation revealed severe hypercalcemia. Confusion persisted after correction of the calcium levels and a diagnosis of primary hyperparathyroidism wassubsequently established on detection of elevatedlevels of serum parathyroid hormone. The patientunderwent parathyroidectomy with a progressiveremission of the neuropsychiatric manifestations.This case illustrates an extremely rare presentingform of primary hyperparathyroidism, consisting inan acute confusional syndrome that persisted aftercorrection of hypercalcemia and that remitted onlyafter surgical treatment of the disease. A brief reviewof the mechanisms involved in the aetiopathogenesisof the neuropsychological manifestations of primaryhyperparathyroidism is presented.