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Primary hyperparathyroidism in an elderly woman: surgical reversibility of profound mental state problems due to mild
C Ann McDonald1, David G Bruce, David J Smith
1Department of Postgraduate Psychiatry Training, Graylands Hospital, Perth, Australia. ann.mcdonald@health .wa.gov.au
Background:
Clinical case of primary hyperparathyroidism in an 89 year old woman causing profound neuropsychiatric symptoms associated with relatively mild increases in serum calcium levels.
Objectives:
To demonstrate that lowering of serum calcium levels by medical treatment (biphosphonate), provided a scientific basis from which to treat a very elderly woman with neuropsychiatric symptoms with definitive surgery.
Method:
Case report.
Results:
The use of biphosphonate therapy led to marked but temporary improvements in her mental state.
Conclusion:
A trial of reducing serum calcium levels with biphosphonate appears to be indicated in elderly patients with mild primary hyperparathyroidism and neuropsychiatric disorders.