title: Mania in a case of hyperparathyroidism.
abstract: Psychiatric manifestations of primary hyperparathyroidism are mediated by hypercalcemia. To date, most evidence indicates that hypercalcemia and increased cerebrospinal-fluid calcium levels produce depression symptoms. Presented here is a case report of a 52-year-old woman in a manic state. She had no psychiatric history but had substantially elevated parathyroid hormone levels and hypercalcemia. On the basis of emerging evidence that calcium channel-blockers effectively treat mania, the authors propose that elevated calcium levels may act through multiple mechanisms or on various regions of the brain to produce a spectrum of psychiatric symptoms that should now include mania as a possibility.
authors.affiliation: Eastern Virginia Medical School, Dept. of Psychiatry and Behavioral Sciences, 825 Fairfax Ave., Norfolk, VA 23507, USA. spiegedr@evms.edu
authors.forename: Scott W
authors.initials: SW
authors.lastname: Brown
authors.forename: Barin V
authors.initials: BV
authors.lastname: Vyas
authors.forename: David R
authors.initials: DR
authors.lastname: Spiegel
mesh_terms: D015746:Abdominal Pain / Q000150:complications; D000236:Adenoma / Q000150:complications / Q000175:diagnosis*; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000628:therapy; D014150:Antipsychotic Agents / Q000008:administration & dosage; D000068180:Aripiprazole; D001569:Benzodiazepines / Q000008:administration & dosage; D001714:Bipolar Disorder / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D001803:Blood Transfusion; D002118:Calcium / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006400:Hematocrit / Q000379:methods; D006454:Hemoglobins; D006801:Humans; D006934:Hypercalcemia / Q000150:complications / Q000523:psychology; D006961:Hyperparathyroidism / Q000150:complications* / Q000523:psychology; D008875:Middle Aged; D009325:Nausea / Q000150:complications; D000077152:Olanzapine; D010281:Parathyroid Hormone / Q000032:analysis; D010282:Parathyroid Neoplasms / Q000150:complications / Q000175:diagnosis*; D010879:Piperazines / Q000008:administration & dosage; D011595:Psychomotor Agitation / Q000150:complications / Q000523:psychology; D015363:Quinolones / Q000008:administration & dosage; D013276:Stomach Ulcer / Q000150:complications; D015431:Weight Loss
chemical_list: D014150:Antipsychotic Agents; D006454:Hemoglobins; D010281:Parathyroid Hormone; D010879:Piperazines; D015363:Quinolones; D001569:Benzodiazepines; D000068180:Aripiprazole; D000077152:Olanzapine; D002118:Calcium