Carolina Paiva, Sandra Assunção, Sofia Moreira, Xenia Verraest, José Eduardo Sousa, Nuno Madureira, António Paiva, Andreia Vilas-Boas
{"title":"超越双相疾病:双相患者的原发性甲状旁腺功能亢进","authors":"Carolina Paiva, Sandra Assunção, Sofia Moreira, Xenia Verraest, José Eduardo Sousa, Nuno Madureira, António Paiva, Andreia Vilas-Boas","doi":"10.15406/emij.2023.11.00332","DOIUrl":null,"url":null,"abstract":"Primary hyperparathyroidism consists of a dysregulated production of parathyroid hormone that results in abnormal calcium homeostasis. It is mostly detected in the asymptomatic phase; however, presentation may include a broad spectrum of clinical manifestations. We describe the case of a 67-year-old female patient with a previous history of bipolar disorder and several vascular risk factors who presented with generalized muscular weakness, anorexia and weight loss, polydipsia, nausea, constipation and mental confusion with behavioural change. Mental and behaviour changes were previously considered a cognitive deficit. Blood tests revealed severe acute renal injury, severe hypercalcemia and frankly increased parathyroid hormone. During hypercalcaemia study, cervical ultrasound identified a nodule compatible with parathyroid adenoma, coincident with hypercaptant focus on the sestamibi scintigraphy. Patient underwent treatment with zolendronic acid and posterior parathyroidectomy with gradual symptomatic and analytical improvement. The authors report this case recalling that psychiatric pathologies can delay the diagnosis of physical conditions.","PeriodicalId":479778,"journal":{"name":"Endocrinology & metabolism international journal","volume":"56 6","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Beyond Bipolar Disease: Primary Hyperparathyroidism in a Bipolar Patient\",\"authors\":\"Carolina Paiva, Sandra Assunção, Sofia Moreira, Xenia Verraest, José Eduardo Sousa, Nuno Madureira, António Paiva, Andreia Vilas-Boas\",\"doi\":\"10.15406/emij.2023.11.00332\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Primary hyperparathyroidism consists of a dysregulated production of parathyroid hormone that results in abnormal calcium homeostasis. It is mostly detected in the asymptomatic phase; however, presentation may include a broad spectrum of clinical manifestations. We describe the case of a 67-year-old female patient with a previous history of bipolar disorder and several vascular risk factors who presented with generalized muscular weakness, anorexia and weight loss, polydipsia, nausea, constipation and mental confusion with behavioural change. Mental and behaviour changes were previously considered a cognitive deficit. Blood tests revealed severe acute renal injury, severe hypercalcemia and frankly increased parathyroid hormone. During hypercalcaemia study, cervical ultrasound identified a nodule compatible with parathyroid adenoma, coincident with hypercaptant focus on the sestamibi scintigraphy. Patient underwent treatment with zolendronic acid and posterior parathyroidectomy with gradual symptomatic and analytical improvement. The authors report this case recalling that psychiatric pathologies can delay the diagnosis of physical conditions.\",\"PeriodicalId\":479778,\"journal\":{\"name\":\"Endocrinology & metabolism international journal\",\"volume\":\"56 6\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-10-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrinology & metabolism international journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15406/emij.2023.11.00332\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrinology & metabolism international journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15406/emij.2023.11.00332","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Beyond Bipolar Disease: Primary Hyperparathyroidism in a Bipolar Patient
Primary hyperparathyroidism consists of a dysregulated production of parathyroid hormone that results in abnormal calcium homeostasis. It is mostly detected in the asymptomatic phase; however, presentation may include a broad spectrum of clinical manifestations. We describe the case of a 67-year-old female patient with a previous history of bipolar disorder and several vascular risk factors who presented with generalized muscular weakness, anorexia and weight loss, polydipsia, nausea, constipation and mental confusion with behavioural change. Mental and behaviour changes were previously considered a cognitive deficit. Blood tests revealed severe acute renal injury, severe hypercalcemia and frankly increased parathyroid hormone. During hypercalcaemia study, cervical ultrasound identified a nodule compatible with parathyroid adenoma, coincident with hypercaptant focus on the sestamibi scintigraphy. Patient underwent treatment with zolendronic acid and posterior parathyroidectomy with gradual symptomatic and analytical improvement. The authors report this case recalling that psychiatric pathologies can delay the diagnosis of physical conditions.