Primary hyperparathyroidism in an elderly woman: surgical reversibility of profound mental state problems due to mild hypercalcaemia.
BACKGROUND
Clinical case of primary hyperparathyroidism in an 89 year old woman causing profound neuropsychiatric symptoms associated with relatively mild increases in serum calcium levels.


OBJECTIVE
To demonstrate that lowering of serum calcium levels by medical treatment (biphosphonate), provided a scientific basis from which to treat a very elderly woman with neuropsychiatric symptoms with definitive surgery.


METHODS
Case report.


RESULTS
The use of biphosphonate therapy led to marked but temporary improvements in her mental state.


CONCLUSIONS
A trial of reducing serum calcium levels with biphosphonate appears to be indicated in elderly patients with mild primary hyperparathyroidism and neuropsychiatric disorders.
Department of Postgraduate Psychiatry Training, Graylands Hospital, Perth, Australia. ann.mcdonald@health .wa.gov.au
C
C
Ann McDonald
David G
DG
Bruce
David J
DJ
Smith
D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000150:complications* / Q000209:etiology; D006961:Hyperparathyroidism / Q000150:complications* / Q000188:drug therapy / Q000601:surgery*; D001523:Mental Disorders / Q000209:etiology*; D016105:Parathyroidectomy
D004164:Diphosphonates