Hyperparathyroidism and Paranoid Psychosis

Alarcón, Renato D.; Franceschini, José A.

doi:10.1192/bjp.145.5.477

Cited by 51 publications

(15 citation statements)

References 24 publications

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“…In chronic hypercalcemia the ability to concentrate and short-term memory are af fected. In severe cases consciousness is blurred, and disorientation and an acute or ganic psychosis may appear [3,12]. There are conflicting views in the literature con cerning the correlation between the severity of the neuropsychiatrie symptoms and the blood calcium levels.…”

Section: Psychiatric Manifestationsmentioning

confidence: 89%

“…There are conflicting views in the literature con cerning the correlation between the severity of the neuropsychiatrie symptoms and the blood calcium levels. Severe hypercalcemia can be accompanied by minimal psychiatric symptoms, while minimal hypercalcemia can be complicated by gross neuropsychiat rie symptomatology [12]. The type of psy chiatric symptoms and their severity can be linked to a number of factors which include premorbid adaptability, the way in which the calcium ions interact with sensitive cen tral nervous system structures and even the patient s sociocultural background [12].…”

Section: Psychiatric Manifestationsmentioning

confidence: 99%

See 1 more Smart Citation

Primary Hyperparathyroidism, Psychiatric Manifestations, Diagnosis and Management

Spivak¹,

Radvan²,

Ohring³

et al. 1989

Psychother Psychosom

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Mental manifestations of primary hyperparathyroidism simulate a wide spectrum of psychiatric disorders. Definitive surgical treatment results in long-lasting full recovery. The 2 cases presented demonstrate this. The clinical diagnostic and therapeutic aspects of primary hyperparathyroidism, with an emphasis on neuropsychiatric manifestations, are discussed. Early diagnosis of hypercalcemia can prevent unnecessary and potentially harmful treatment with antidepressive, anxiolytic or antipsychotic drugs, which can further depress the cognitive state of the patients, and can aggravate the mental symptoms.

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Section: Psychiatric Manifestationsmentioning

confidence: 89%

Section: Psychiatric Manifestationsmentioning

confidence: 99%

Primary Hyperparathyroidism, Psychiatric Manifestations, Diagnosis and Management

Spivak¹,

Radvan²,

Ohring³

et al. 1989

Psychother Psychosom

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“…(4) não observaram correlação direta entre os níveis de cálcio e os sintomas psiquiátricos, descrevendo pacientes com hipercalcemia grave e sintomas psiquiátricos frustros, e outros com hipercalcemia leve e sintomas psiquiátricos graves. Essa falta de correlação não foi observada entre pacientes acima de 50 anos e/ou com doenças psiquiátricas prévias (16). Os sintomas psiquiátricos ocorrem mais freqüente-mente em mulheres, provavelmente associados à maior prevalência de hiperparatiroidismo (16).…”

Section: Hiperparatiroidismo Primário No Idosounclassified

“…Essa falta de correlação não foi observada entre pacientes acima de 50 anos e/ou com doenças psiquiátricas prévias (16). Os sintomas psiquiátricos ocorrem mais freqüente-mente em mulheres, provavelmente associados à maior prevalência de hiperparatiroidismo (16).…”

Section: Hiperparatiroidismo Primário No Idosounclassified

Manifestações neuropsiquiátricas do hiperparatiroidismo primário no idoso: relato de casos e revisão da literatura

Frisoli

D’Amorin

Szejnfeld

et al. 2001

Arq Bras Endocrinol Metab

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Arq Bras Endocrinol Metab vol 45 nº 3 Junho 2001 302 RESUMOA osteoporose e os distúrbios neuropsiquiátricos surgem com maior freqüência entre os pacientes idosos, quando comparados com as demais faixas etárias. Manifestações concomitantes destas síndromes podem apresentar causas comuns. Neste artigo, nós descrevemos os casos de duas mulheres com osteoporose estabelecida e idades de 75 e 80 anos, que desenvolveram sinais e sintomas neuropsiquiátricos (apatia, fraqueza, depressão e perda de memória) associados a hipercalcemia [cálcio iônico de 1,43mmol/L e 1,65mmol/L (1,14 -1,30mmol/L), respectivamente]. Na investigação laboratorial foi observado que os níveis da fração intacta do paratormônio (PTHi) estavam dentro dos limites da normalidade (64 e 63pg/ml, respectivamente) ou não suprimidos. Após exploração cirúrgica cervical foram removidas, de cada paciente, massas tumorais únicas, cujo anátomo-patológico revelou adenoma de paratireóide. As duas pacientes apresentaram melhora dos sintomas e sinais neuropsiquiátricos após a cirurgia e a segunda paciente obteve ganho de massa óssea significativo, sem uso de qualquer droga antireabsortiva. A outra paciente não pode ser avaliada através da densitometria óssea, devido às deformidades na coluna torácica. A possibilidade de HPTP deve ser sempre considerada, principalmente em pacientes com níveis de paratormônio dentro da faixa de normalidade, ou não suprimidos apesar de cálcio ionizado elevado. Isso ocorre devido a alguns tumores de paratireóide apresentarem set point alterado em relação aos níveis de cálcio mas sem aumento significativo da produção de paratormônio. Outra correlação observada é que quanto menor forem os adenomas, maior a chance de serem hipersecretores e autônomos. Em conclusão, a aferição do cálcio iônico em pacientes idosos com osteoporose e ou sintomas e sinais neuropsiquiátricos deve ser feita de rotina com o objetivo de se excluir doenças que possam ser tratadas prontamente e com bons resultados. ABSTRACTOsteoporosis and neuropsychiatric disorders occur more frequently in elderly than in young people. When they appear together there is a possibility of a common etiology. We report two cases of elderly women at the ages of 75 and 80y with established osteoporosis and neuropsychiatric manifestations (apathy, weakness, depression and loss of memory) caused by hypercalcemia (ionic calcium of 1.43mmol/L and 1.65mmol/L, respectively) due to primary hyperparathyroidism (PHPT). Other laboratory results showed normal levels of the intact fraction of parathormone (iPTH), i.e. 64 and 63pg/ml, respectively. They were submitted to parathyroidectomy and only one tumoral mass was removed from each woman. Pathologic examination showed parathyroid adenoma. Shortly after the surgery they got better of the neuropsychiatric signs and symptoms. Six months later the bone mineral density (BMD) of the apresentação de caso

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“…Apart from the triad 'stones, bones and abdominal groans' [12], sHPT is known to be quite often accompa nied by depressive syndromes and cognitive disorders ('mental moan') in the sense of Bleuler's endocrine psy chosyndrome [13][14][15][16][17][18], Prevalence rates of depressive dis orders vary between 23 and 100%. They are, however, almost entirely based upon clinical diagnoses.…”

Section: Neuropsy'chiatric Symptoms In Primary Hptmentioning

confidence: 99%

Secondary Hyperparathyroidism and Depression in Chronic Renal Failure

Driessen¹,

Wetterling²,

Wedel³

et al. 1995

Nephron

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This study was aimed at examining the relation between secondary hyperparathyroidism (sHPT) and depressive syndromes in chronic renal failure (CRF). Sample and methods: 59 chronic CRF patients and 16 depressive patients without CRF were included. Parathyroid hormone (PTH), calcium and phosphate as well as psychopathology were measured. Results: Depressive CRF patients with cognitive disorders show higher levels of PTH than less or not depressive subjects. With respect to the literature, our results give reason to assume that sHPT may play a pathogenetic role in those depressive syndromes which are additionally characterized by cognitive disorders.

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Hyperparathyroidism and Paranoid Psychosis

Cited by 51 publications

References 24 publications

Primary Hyperparathyroidism, Psychiatric Manifestations, Diagnosis and Management

Primary Hyperparathyroidism, Psychiatric Manifestations, Diagnosis and Management

Manifestações neuropsiquiátricas do hiperparatiroidismo primário no idoso: relato de casos e revisão da literatura

Secondary Hyperparathyroidism and Depression in Chronic Renal Failure

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