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Ectopic parathyroid adenoma causing hyperparathyroidism-induced psychosis: A case report
David Corredor-Orlandelli1,2, Laura Valenzuela-Vallejo1,2, Juan Felipe Aguirre-Ruiz2,3
1School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia.
SAGE Open Medical Case Reports
|July 12, 2023
Summary
Psychosis can be a rare initial symptom of primary hyperparathyroidism. Treating the underlying hypercalcemia caused by parathyroid adenoma resolved the patient's psychotic episode.
Area of Science:
- Endocrinology
- Neuropsychiatry
Background:
- Primary hyperparathyroidism (PHP) is a condition marked by elevated parathormone levels, leading to diverse systemic effects.
- Neuropsychiatric symptoms, including psychosis, are uncommon but recognized manifestations of PHP.
Observation:
- A 68-year-old female presented with anorexia, mutism, dysphagia, constipation, and weight loss over 10 days.
- She exhibited disorganized speech and paranoid delusions, initially misdiagnosed as a mixed anxiety-depressive disorder and treated unsuccessfully with antidepressants and antipsychotics.
Findings:
- Neuroimaging, infectious workup, and toxicology were unremarkable.
- The patient's psychosis and other symptoms were attributed to hypercalcemia caused by a retropharyngeal ectopic parathyroid adenoma.
Implications:
- This case underscores the importance of considering psychosis as a potential early sign of primary hyperparathyroidism and hypercalcemia.
- It highlights the necessity of ruling out organic causes, such as hypercalcemia, before diagnosing primary psychiatric disorders, as treating the underlying condition can reverse symptoms.
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