Primary hyperparathyroidism. Laboratory and clinical data in 73 cases

Hecht, Anna

doi:10.1001/jama.233.6.519

Cited by 8 publications

(6 citation statements)

References 17 publications

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“…Other studies did not verify these findings [7]. In SHPT, changes in the metabolism of some neurotransmitters have been reported [7]. In our study the serum Ca and P levels of all the patients with depression were normal, and brain scans revealed no cerebral calcification.…”

Section: Introductioncontrasting

confidence: 60%

“…It has also been reported that cerebral functions showed improvement after parathyroidectomy [5], that electroencephalographic changes are related to PTH [4] and that development of uremic encephalopathy results from cerebral Ca overload [6]. Other studies did not verify these findings [7]. In SHPT, changes in the metabolism of some neurotransmitters have been reported [7].…”

Section: Introductionmentioning

confidence: 99%

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Depression and Secondary Hyperparathyroidism in Chronic Renal Failure

Cengiz¹,

Özkan

1998

Nephron

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Section: Introductioncontrasting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Depression and Secondary Hyperparathyroidism in Chronic Renal Failure

Cengiz¹,

Özkan

1998

Nephron

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mentioning

confidence: 99%

“…Mental symptoms have been found in 5-50% of patients with primary HPT [1,[6][7][8][9]. The most common disturbances reported on are depression, confusional states, and neurasthenic behavior [1,[6][7][8][9]. Case studies have suggested complete reversion of the psychiatric illness after successful parathyroid surgery [6,10,11], but detailed analysis of the mental disturbances and the effect of parathyroid surgery has not been performed in consecutive patients with primary HPT.…”

mentioning

confidence: 99%

Psychiatric morbidity in primary hyperparathyroidism

et al. 1988

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This report deals with the psychiatric symptomatology in patients with primary hyperparathyroidism (HPT). In a retrospective search of hospital records, psychiatric symptoms were found in 102 (23%) of 441 patients, 78 of whom had depressive and anxiety states. The presence of psychiatric symptoms was not related to the degree of hypercalcemia. Screening for HPT in 101 old patients hospitalized at a psychogeriatric clinic revealed HPT in 5 (5%) patients. Among 13 patients with organic brain syndrome (e.g., senile dementia) and HPT, 8 patients (with a duration of psychiatric illness of less than 2 years) improved mentally after parathyroid surgery, and could return home or to somatic units. The psychiatric symptomatology was prospectively investigated in 59 consecutive patients with primary HPT (mean serum calcium, 2.89±0.30 mmol/l), using the Comprehensive Psychopathological Rating Scale (CPRS). A majority of the patients had considerable psychiatric symptoms (mean CPRS total score, 13.7±9.1) compared with a healthy control group (mean CPRS total score, 4.4±2.0;p <0.001). The most pronounced psychiatric symptoms among the patients were fatiguability, lassitude, failing memory, concentration difficulties, sadness, and inner tension. Analysis of monoamine metabolites in the cerebrospinal fluid in 48 of the patients revealed subnormal values of 5‐hydroxyindoleaceticacid (5‐HIAA) and homovanillic acid (HVA). At follow‐up, 1–1 1/2 years after parathyroid surgery, there was a marked improvement in mental health in the patients (p <0.001), together with a significant rise in the levels of 5‐HIAA and HVA (p <0.05). Our findings demonstrate that psychiatric symptoms are present in a majority of patients with primary HPT, that the symptoms are reversed by parathyroid surgery, and that their severity seems not to be related to the degree of hypercalcemia. The results also indicate that HPT is associated with changes in the central nervous system turnover of monoamines, of possible importance for the symptomatology.

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“…Some may question its inclusion in our survey, but we thought it was valid because, besides documenting clearly a genetic component, it hypothesises a linkage between HPPT and predisposition to affective disor ders. In fact, his case summaries (three male, seven female patients) reflect overwhelming evidence of affective symptoms, no evidence of psychotic or organic phenomena, and only one case of phobic and obsessive-compulsive behaviour which, in any case, has been ascribed to depressive syndromes by a number of authors (Kendell & Di Scipio, 1970). Hecht et al (1975 were the first to emphasise that lethargy, apathy, and depression were present only in those patients 55 years of age and older.…”

Section: Series Of Patientsmentioning

confidence: 96%

Hyperparathyroidism and Paranoid Psychosis

Alarcón

Franceschini

1984

Br J Psychiatry

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Literature on psychiatric manifestations of hyperparathyroidism published in the last four decades confirms the unusual features of a case of paranoid psychosis secondary to a parathyroid-adenoma-induced hypercalcaemia. Affective and organic symptoms are overwhelmingly dominant in hypercalcaemic patients; the majority of cases reported are women of 50 years or older, who have been vaguely ill for a prolonged time before the actual endocrinopathy appears. The severity of the psychiatric symptoms does not seem to be related to the degree of hypercalcaemia. Recent findings link the role of calcium and related ions in the production of psychopathological symptoms to membrane phenomena, dopaminergic activity, and neuroendocrine regulation.

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Primary hyperparathyroidism. Laboratory and clinical data in 73 cases

Cited by 8 publications

References 17 publications

Depression and Secondary Hyperparathyroidism in Chronic Renal Failure

Depression and Secondary Hyperparathyroidism in Chronic Renal Failure

Psychiatric morbidity in primary hyperparathyroidism

Hyperparathyroidism and Paranoid Psychosis

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