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Hypocalcemia-Induced Reversible Psychosis.

Andrea Hall1, Talha Bin Farooq2, Renato Alcaraz2

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Summary
This summary is machine-generated.

Severe hypocalcemia, a calcium imbalance, can trigger acute psychosis. Prompt calcium correction rapidly resolved psychotic symptoms in a patient with a history of thyroidectomy and hypoparathyroidism, highlighting a treatable cause of psychosis.

Keywords:
delusionshypoparathyroidismmetabolic psychosisreversibles: hypocalcemia

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Area of Science:

  • Endocrinology
  • Neuropsychiatry
  • Medical Case Study

Background:

  • Hypocalcemia presents with diverse symptoms, including neuromuscular and psychiatric manifestations.
  • Acute psychosis is a rare but serious neuropsychiatric complication of severe hypocalcemia.
  • Postsurgical hypoparathyroidism following thyroidectomy can lead to chronic hypocalcemia.

Observation:

  • A 24-year-old woman with a history of MEN2B and postsurgical hypoparathyroidism presented with acute psychosis, confusion, and agitation.
  • The patient exhibited psychotic features including hallucinations and delusions, with laboratory findings revealing severe hypocalcemia and low parathyroid hormone.
  • Workup excluded infectious, inflammatory, and autoimmune etiologies for the psychosis.

Findings:

  • Intravenous calcium gluconate and subsequent calcitriol treatment normalized calcium levels.
  • Psychotic symptoms rapidly resolved following correction of hypocalcemia.
  • This case represents new-onset acute psychosis attributed to calcium dysregulation without cortical calcifications.

Implications:

  • Recognizing hypocalcemia as a potential cause of psychosis is crucial for accurate diagnosis and timely treatment.
  • This case underscores the importance of medication compliance in patients with hypoparathyroidism to prevent severe metabolic disturbances.
  • Prompt management of hypocalcemia can lead to rapid resolution of neuropsychiatric symptoms, preventing misdiagnosis as primary psychiatric disorders.