title: Hypercalcaemia mimicking Huntington's disease: lessons learned from delayed diagnosis.
abstract: Diagnosis can prove challenging when a patient with a chronic neurological disease presents with acute deterioration. This is especially true in Huntington's disease, where cognitive impairment is prominent. We present a case of hypercalcaemia causing an acute deterioration in physical and cognitive function in a patient with Huntington's disease. Similarity in clinical phenotype between hypercalcaemia and Huntington's disease, as well as failure to appreciate the acute nature of the deterioration resulted in diagnostic delay and prolonged admission. With treatment, the patient improved dramatically. The case highlights key learning points regarding assessment of patients with chronic neurological disease.
authors.affiliation: J Hrastelj, Neurology Research Office, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK. Email hrasteljj@cardiff.ac.uk.
authors.forename: J
authors.initials: J
authors.lastname: Hrastelj
authors.forename: D
authors.initials: D
authors.lastname: McLauchlan
authors.forename: A
authors.initials: A
authors.lastname: Rosser
authors.forename: C
authors.initials: C
authors.lastname: Clenaghan
mesh_terms: D000328:Adult; D002118:Calcium / Q000097:blood; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000150:complications*; D006934:Hypercalcemia / Q000175:diagnosis* / Q000209:etiology; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000175:diagnosis*
chemical_list: D002118:Calcium
keywords: Huntington's disease; acute; deterioration; diagnosis; heuristics; hypercalcaemia