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Case Report
Primary hyperparathyroidism presenting as subacute encephalopathy: A case report and review of literature
1 Department of Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
2 Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA
Address correspondence to:
Jennifer E Rosen
MD, Chief, Division of Endocrine Surgery, MedStar Washington Hospital Center, 106 Irving Street Northwest, Suite 124, Washington, DC,
USA
Message to Corresponding Author
Article ID: 101171Z01DB2020
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How to cite this article
Barrak D, Deldar R, Merle C, Brannon III A, Jackson II D, Rosen JE. Primary hyperparathyroidism presenting as subacute encephalopathy: A case report and review of literature. Int J Case Rep Images 2020;11:101171Z01DB2020.ABSTRACT
Introduction: Altered mental status can be a reflection of any systemic disease. Endocrinopathies such as hypercalcemia and hyperparathyroidism are among those that may present with such neurologic symptoms. The aim of this case report is to emphasize that primary hyperparathyroidism (PHPT) should be considered as a possible diagnosis in patients who present with a decline in neurological function.
Case Report: Our case report details a patient with history of PHPT and breast cancer who presented with progressive neurocognitive decline, abnormal hyperkinetic involuntary movements, weight loss, and decline in functional status over the past year. Extensive workup including laboratory data, imaging, lumbar puncture, and gene panels were unremarkable. The patient underwent parathyroidectomy with improvement in her neurocognitive and functional status postoperatively.
Conclusion: Parathyroidectomy has favorable outcomes when performed early in elderly patients who present with hypercalcemic encephalopathy due to primary hyperparathyroidism. Hypercalcemia and primary hyperparathyroidism should be considered in the differential diagnosis of altered mental status, especially in the elderly population.
Keywords: Encephalopathy, Endocrine surgery, Parathyroidectomy, Primary hyperparathyroidism
SUPPORTING INFORMATION
Author Contributions
Dany Barrak - Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Romina Deldar - Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Chamilka Merle - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Arthur Brannon III - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Darren Jackson II - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Jennifer E Rosen - Substantial contributions to conception and design, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Dany Barrak et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
