An Atypical Presentation of Primary Hyperparathyroidism in an Adolescent: A Case Report of Hypercalcaemia and Neuropsychiatric Symptoms Due to a Mediastinal Parathyroid Adenoma
| Autor: | Pierpacifico Gismondi, Susanna Esposito, Rosanna Iannarella, Umberto Fanelli, Aniello Meoli, Alessandra Tiri, Roberta Minelli |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Parathyroidectomy Pediatrics medicine.medical_specialty Hypercalcaemia endocrine system diseases Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Case Report lcsh:Diseases of the endocrine glands. Clinical endocrinology 03 medical and health sciences 0302 clinical medicine Endocrinology Quality of life medicine primary hyperparathyroidism Depression (differential diagnoses) Parathyroid adenoma lcsh:RC648-665 business.industry hypercalcaemia medicine.disease 030104 developmental biology psychiatric disorders Anorexia nervosa (differential diagnoses) mediastinal parathyroid adenoma neuropsychiatric symptoms business Neurocognitive Primary hyperparathyroidism |
| Zdroj: | Frontiers in Endocrinology Frontiers in Endocrinology, Vol 11 (2020) |
| ISSN: | 1664-2392 |
| Popis: | Psychiatric disorders are rare clinical manifestations of hypercalcaemia in the pediatric population, are relatively more frequent during adolescence and are often overlooked in cases of severe hypercalcaemia. We described the case of a 17-year-old girl affected by anorexia nervosa, depression and self-harm with incidental detection of moderate hypercalcaemia. Clinical, laboratory and instrumental tests demonstrated that hypercalcaemia was secondary to primary hyperparathyroidism (PHPT) due to a mediastinal parathyroid adenoma in the thymic parenchyma. After parathyroidectomy with robot-assisted surgery, we observed the restoration of calcium and PTH levels in addition to an improvement in psychiatric symptoms. This case demonstrates that serum calcium concentration should be evaluated in adolescents with neurobehavioural symptoms and in cases of hypercalcaemia PHPT should be excluded. Surgery represents the cornerstone of the management of PHPT and may contribute to improving quality of life and psychological function in these patients. However, the complexity of neurological involvement in cases of hypercalcaemia due to PHPT requires further investigations to establish the real impact of this condition on the neurocognitive sphere. |
| Databáze: | OpenAIRE |
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