[Acute confusional syndrome as first manifestation of primary hyperparathyroidism]

Hyperparathyroid crisis is an uncommon clinical state characterized by severe hypercalcemia which can produce an acute confusional syndrome (ACS) or delirium. We are reporting the case of a 58-year male with calcemias greater than 14 mg/dl, that were due to a parathyroid adenoma (primary hyperparathyroidism), and caused his admission in UCI with change in the conscience level, global afectation of the cognitive functions, letargia and disorentiation among other clinical symptoms. The patient was operated by our Service on lower left parathyroidectomy with PTH rapid or turbo assay and decreasing such hormone levels about 75%. After the surgery his evolution was satisfactory obtaining the normocalcemia.