Beyond Bipolar Disease: Primary Hyperparathyroidism in a Bipolar Patient

• DOI: 10.15406/emij.2023.11.00332
• Publication Date: 2023-11-10T05:11:13Z
• Authors: Carolina Paiva; Sandra Assunção; Sofia Moreira; Xenia Verraest; José Eduardo Sousa; Nuno Madureira; António Paiva; Andreia Vilas-Boas
• Keywords: Polyuria; Hypercalcaemia

Primary hyperparathyroidism consists of a dysregulated production parathyroid hormone that results in abnormal calcium homeostasis. It is mostly detected the asymptomatic phase; however, presentation may include broad spectrum clinical manifestations. We describe case 67-year-old female patient with previous history bipolar disorder and several vascular risk factors who presented generalized muscular weakness, anorexia weight loss, polydipsia, nausea, constipation mental confusion behavioural change. Mental behaviour changes were previously considered cognitive deficit. Blood tests revealed severe acute renal injury, hypercalcemia frankly increased hormone. During hypercalcaemia study, cervical ultrasound identified nodule compatible adenoma, coincident hypercaptant focus on sestamibi scintigraphy. Patient underwent treatment zolendronic acid posterior parathyroidectomy gradual symptomatic analytical improvement. The authors report this recalling psychiatric pathologies can delay diagnosis physical conditions.