This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Olukoga, A. Search for Related Content Social Bookmarking                         What's this?

Lessons to be learned: a case study approach

Primary hyperparathyroidism simulating an acute severe polyneuritis

Chemical Pathology, Department of Clinical Biochemistry, Hope Hospital, Salford, Manchester

The case is presented of a 65 year old lady with recent onset of neuromuscular manifestations, comprising paraparesis, areflexia and unsteady gait, along with episodes of slurring of speech and diplopia, later confirmed to be due to severe hypercalcaemia - which itself was caused by primary hyperparathyroidism. Restoration of normocalcaemia, by means of rehydration and bisphosphonate therapy, resulted in clinical improvement - whilst subsequent parathyroidectomy was followed by complete resolution of all symptoms. In order to make prompt differentiation between the neurological sequelae of hyperparathyroidism and a primary neurological disorder, a high index of suspicion is required. An urgent serum calcium assay, as part of a bone profile, is mandatory in patients who present with neurological symptoms - especially the elderly, amongst whom hyperparathyroidism is especially common.

Key Words: Areflexia • diplopia • hypercalcaemia • paraparesis • primary hyperparathyroidism

The Journal of the Royal Society for the Promotion of Health, Vol. 118, No. 2, 103-106 (1998)
DOI: 10.1177/146642409811800211


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?