Parkinsonismo como síntoma principal de hiperparatiroidismo: recuperación tras cirugía

Luján-Martínez, Delia; Sánchez-Cifuentes, Ángela; Peña-Ros, Emilio; Albarracín-Marín-Blázquez, Antonio; Candel-Arenas, Mari Fe

doi:10.24875/ciru.m18000010

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…In light of such data, it is not surprising that patients with PD exhibit high PTH levels. In a few anecdotal reports, authors described patients with concomitant parkinsonism and hyperparathyroidism ( 10 , 11 ), questioning if the latter was an incidental finding or a causative condition; noteworthy surgical removal of the parathyroid glands improved symptoms.…”

Section: Discussionmentioning

confidence: 99%

Leg restlessness and hyperparathyroidism in Parkinson's disease, a further clue to RLS pathogenesis?

Marano

Pozzilli²,

Magliozzi³

et al. 2023

Front. Neurol.

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BackgroundNon-motor manifestations are the main features of Parkinson's disease (PD). These have been associated with vitamin D abnormalities, but the role of parathormone (PTH) is still obscure. Among the non-motor symptoms of PD, the pathogenesis of restless leg syndrome (RLS) is still debated, but it has been associated with the vitamin D/PTH axis in other disease models. Our study deepens the association between vitamin D and PTH with the prevalence of non-motor symptoms of PD and explores such a relationship in patients reporting leg restlessness.MethodsFifty patients with PD were extensively investigated with motor and non-motor scales. Data on serum levels of vitamin D, PTH, and related metabolites were obtained, and patients were stratified as having vitamin D deficiency or hyperparathyroidism according to standardized criteria.ResultsOverall, 80% of patients with PD exhibited low vitamin D levels, and hyperparathyroidism was diagnosed in 45%. The analysis of the non-motor symptoms profile using the non-motor symptom questionnaire (NMSQ) revealed 36% of leg restlessness, a main feature of RLS. This was significantly associated with worse motor symptoms, quality of sleep, and quality of life. Moreover, it was associated with hyperparathyroidism (OR: 3.48) and with PTH levels, independent of vitamin D, calcium/phosphate levels, and motor status.ConclusionOur results suggest a significant association between the vitamin D/PTH axis and leg restlessness in PD. PTH has a putative role in nociceptive modulation, and previous evidence on hyperparathyroidism has suggested a possible interrelation with RLS. Further investigations are necessary to add PTH to the non-dopaminergic non-motor landscape of PD.

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Section: Discussionmentioning

confidence: 99%

Leg restlessness and hyperparathyroidism in Parkinson's disease, a further clue to RLS pathogenesis?

Marano

Pozzilli²,

Magliozzi³

et al. 2023

Front. Neurol.

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Parkinsonism as an Atypical Manifestation of Primary Hyperparathyroidism

Augusto

Morais

Santana

et al. 2019

AACE Clinical Case Reports

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Objective: Primary hyperparathyroidism (PHPT) occurs as a result of hyperfunctional parathyroid glands resulting in an elevation of serum calcium levels. The association between hypoparathyroidism and parkinsonism have been frequently reported in the literature, while evidence of hyperparathyroidism associated with parkinsonism is rare. Methods: The present study reports a case of a patient that had PHPT and developed symptoms of parkinsonism. Results: A 75-year-old female patient with a history of diabetes mellitus, dyslipidemia, and systemic arterial hypertension presented to the emergency room due to unexplained drowsiness. Her serum calcium at the time was 14.2 mg/dL. A cervical ultrasound was performed, and the presence of a 2.5 × 1.9-cm nodule in the left lower parathyroid region was identified. Three days later, scintigraphy with the use of sestamibi showed an increased capture of the marker in the same region, suggesting parathyroid hyperfunction. During hospitalization, the patient developed symptoms of parkinsonism. A left inferior parathyroidectomy was performed, with normalization of serum calcium levels and a remission of drowsiness, in addition to a significant improvement in parkinsonian symptoms. The patient remained free of parkinsonism over 3 years of follow up. Conclusion: Parathyroidectomy can provide a significant remission of parkinsonism in a patient with PHPT. Even though it is rare, the relation between parkinsonism and PHPT exists. (AACE Clinical Case Rep.

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Parkinsonismo como síntoma principal de hiperparatiroidismo: recuperación tras cirugía

Abstract: Cognitive impairment of the elderly due to a parathyroid adenoma is underdiagnosed, behavioral changes and alterations of motor functions are attributed to age, dementia and frailty, representing a diagnostic challenge.

Cited by 2 publications

References 5 publications

Leg restlessness and hyperparathyroidism in Parkinson's disease, a further clue to RLS pathogenesis?

Leg restlessness and hyperparathyroidism in Parkinson's disease, a further clue to RLS pathogenesis?

Parkinsonism as an Atypical Manifestation of Primary Hyperparathyroidism

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