An Atypical Presentation of Primary Hyperparathyroidism in an Adolescent: A Case Report of Hypercalcaemia and Neuropsychiatric Symptoms Due to a Mediastinal Parathyroid Adenoma
Psychiatric disorders are rare clinical manifestations of hypercalcaemia in the pediatric population, are relatively more frequent during adolescence and are often overlooked in cases of severe hypercalcaemia. We described the case of a 17-year-old girl affected by anorexia nervosa, depression and s...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2020-09-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fendo.2020.581765/full |
| _version_ | 1818277385772990464 |
|---|---|
| author | Roberta Minelli Aniello Meoli Alessandra Tiri Umberto Fanelli Rosanna Iannarella Pierpacifico Gismondi Susanna Esposito |
| author_facet | Roberta Minelli Aniello Meoli Alessandra Tiri Umberto Fanelli Rosanna Iannarella Pierpacifico Gismondi Susanna Esposito |
| author_sort | Roberta Minelli |
| collection | DOAJ |
| description | Psychiatric disorders are rare clinical manifestations of hypercalcaemia in the pediatric population, are relatively more frequent during adolescence and are often overlooked in cases of severe hypercalcaemia. We described the case of a 17-year-old girl affected by anorexia nervosa, depression and self-harm with incidental detection of moderate hypercalcaemia. Clinical, laboratory and instrumental tests demonstrated that hypercalcaemia was secondary to primary hyperparathyroidism (PHPT) due to a mediastinal parathyroid adenoma in the thymic parenchyma. After parathyroidectomy with robot-assisted surgery, we observed the restoration of calcium and PTH levels in addition to an improvement in psychiatric symptoms. This case demonstrates that serum calcium concentration should be evaluated in adolescents with neurobehavioural symptoms and in cases of hypercalcaemia PHPT should be excluded. Surgery represents the cornerstone of the management of PHPT and may contribute to improving quality of life and psychological function in these patients. However, the complexity of neurological involvement in cases of hypercalcaemia due to PHPT requires further investigations to establish the real impact of this condition on the neurocognitive sphere. |
| first_indexed | 2024-12-12T23:00:42Z |
| format | Article |
| id | doaj.art-9f2f6a535770421388b2eaecd738e351 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-12T23:00:42Z |
| publishDate | 2020-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-9f2f6a535770421388b2eaecd738e3512022-12-22T00:08:50ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922020-09-011110.3389/fendo.2020.581765581765An Atypical Presentation of Primary Hyperparathyroidism in an Adolescent: A Case Report of Hypercalcaemia and Neuropsychiatric Symptoms Due to a Mediastinal Parathyroid AdenomaRoberta Minelli0Aniello Meoli1Alessandra Tiri2Umberto Fanelli3Rosanna Iannarella4Pierpacifico Gismondi5Susanna Esposito6Thyroid Unit, Medical Clinic, Department of Medicine and Surgery, University of Parma, Parma, ItalyPediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, ItalyPediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, ItalyPediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, ItalyPediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, ItalyPediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, ItalyPediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, ItalyPsychiatric disorders are rare clinical manifestations of hypercalcaemia in the pediatric population, are relatively more frequent during adolescence and are often overlooked in cases of severe hypercalcaemia. We described the case of a 17-year-old girl affected by anorexia nervosa, depression and self-harm with incidental detection of moderate hypercalcaemia. Clinical, laboratory and instrumental tests demonstrated that hypercalcaemia was secondary to primary hyperparathyroidism (PHPT) due to a mediastinal parathyroid adenoma in the thymic parenchyma. After parathyroidectomy with robot-assisted surgery, we observed the restoration of calcium and PTH levels in addition to an improvement in psychiatric symptoms. This case demonstrates that serum calcium concentration should be evaluated in adolescents with neurobehavioural symptoms and in cases of hypercalcaemia PHPT should be excluded. Surgery represents the cornerstone of the management of PHPT and may contribute to improving quality of life and psychological function in these patients. However, the complexity of neurological involvement in cases of hypercalcaemia due to PHPT requires further investigations to establish the real impact of this condition on the neurocognitive sphere.https://www.frontiersin.org/article/10.3389/fendo.2020.581765/fullhypercalcaemiamediastinal parathyroid adenomaneuropsychiatric symptomsprimary hyperparathyroidismpsychiatric disorders |
| spellingShingle | Roberta Minelli Aniello Meoli Alessandra Tiri Umberto Fanelli Rosanna Iannarella Pierpacifico Gismondi Susanna Esposito An Atypical Presentation of Primary Hyperparathyroidism in an Adolescent: A Case Report of Hypercalcaemia and Neuropsychiatric Symptoms Due to a Mediastinal Parathyroid Adenoma Frontiers in Endocrinology hypercalcaemia mediastinal parathyroid adenoma neuropsychiatric symptoms primary hyperparathyroidism psychiatric disorders |
| title | An Atypical Presentation of Primary Hyperparathyroidism in an Adolescent: A Case Report of Hypercalcaemia and Neuropsychiatric Symptoms Due to a Mediastinal Parathyroid Adenoma |
| title_full | An Atypical Presentation of Primary Hyperparathyroidism in an Adolescent: A Case Report of Hypercalcaemia and Neuropsychiatric Symptoms Due to a Mediastinal Parathyroid Adenoma |
| title_fullStr | An Atypical Presentation of Primary Hyperparathyroidism in an Adolescent: A Case Report of Hypercalcaemia and Neuropsychiatric Symptoms Due to a Mediastinal Parathyroid Adenoma |
| title_full_unstemmed | An Atypical Presentation of Primary Hyperparathyroidism in an Adolescent: A Case Report of Hypercalcaemia and Neuropsychiatric Symptoms Due to a Mediastinal Parathyroid Adenoma |
| title_short | An Atypical Presentation of Primary Hyperparathyroidism in an Adolescent: A Case Report of Hypercalcaemia and Neuropsychiatric Symptoms Due to a Mediastinal Parathyroid Adenoma |
| title_sort | atypical presentation of primary hyperparathyroidism in an adolescent a case report of hypercalcaemia and neuropsychiatric symptoms due to a mediastinal parathyroid adenoma |
| topic | hypercalcaemia mediastinal parathyroid adenoma neuropsychiatric symptoms primary hyperparathyroidism psychiatric disorders |
| url | https://www.frontiersin.org/article/10.3389/fendo.2020.581765/full |
| work_keys_str_mv | AT robertaminelli anatypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT aniellomeoli anatypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT alessandratiri anatypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT umbertofanelli anatypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT rosannaiannarella anatypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT pierpacificogismondi anatypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT susannaesposito anatypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT robertaminelli atypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT aniellomeoli atypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT alessandratiri atypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT umbertofanelli atypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT rosannaiannarella atypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT pierpacificogismondi atypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma AT susannaesposito atypicalpresentationofprimaryhyperparathyroidisminanadolescentacasereportofhypercalcaemiaandneuropsychiatricsymptomsduetoamediastinalparathyroidadenoma |