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Cognitive decline due to ectopic primary hyperparathyroidism.

Yoshito Nishimura¹, Akira Yamamoto¹, Masahiro Takahara¹

¹Department of General Medicine, Dentistry and Pharmaceutical Sciences Okayama University Graduate School of Medicine Okayama Japan.

Clinical Case Reports

|December 20, 2018

Summary

This summary is machine-generated.

Hypercalcemia from hyperparathyroidism can cause cognitive dysfunction. Consider chest CT and 131I-MIBI SPECT imaging for diagnosing hyperparathyroidism when thyroid ultrasound is normal.

Keywords:

131I‐MIBI ectopic parathyroid adenoma hypercalcemia hyperparathyroidism

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Area of Science:

Endocrinology
Nuclear Medicine
Radiology

Background:

Cognitive dysfunction is a common clinical presentation.
Hypercalcemia is a potential cause of cognitive impairment.
Hyperparathyroidism is a frequent cause of hypercalcemia.

Purpose of the Study:

To highlight hypercalcemia due to hyperparathyroidism as a differential diagnosis for cognitive dysfunction.
To recommend advanced imaging techniques for diagnosing hyperparathyroidism in specific clinical scenarios.

Main Methods:

Review of clinical cases presenting with cognitive dysfunction and hypercalcemia.
Evaluation of diagnostic imaging modalities including chest computed tomography (CT) and iodine-131-labeled methoxyisobutylnitrile (131I-MIBI) SPECT.
Comparison of imaging findings with thyroid ultrasound results.

Main Results:

Hypercalcemia secondary to hyperparathyroidism is a significant, often overlooked, cause of cognitive dysfunction.
Chest CT and 131I-MIBI SPECT can be valuable in localizing parathyroid adenomas when initial thyroid ultrasound is unrevealing.
These imaging techniques aid in the diagnosis of hyperparathyroidism, facilitating timely treatment and management of cognitive symptoms.

Conclusions:

Hyperparathyroidism should be considered in the differential diagnosis of patients with cognitive dysfunction and hypercalcemia.
Chest CT and 131I-MIBI SPECT are recommended imaging strategies for patients with suspected hyperparathyroidism and a normal thyroid ultrasound, improving diagnostic yield.