From Psychiatry to Neurology and Endocrinology: A Case of Hypoparathyroidism

A 31-year-old male patient developed extrapyramidal symptoms while on treatment for depression. He was investigated and found to suffer from hypoparathyroidism. He had calcification in the brain, signs and symptoms of neuromuscular irritability, and QT prolongation on electrocardiogram. He was treated with calcium carbonate and calcitriol. Although he had marked improvement, bradykinesia persisted. This report highlights the importance of maintaining a high index of suspicion for hypocalcemia, and the importance of searching for an organic basis for psychiatric symptoms.

[1]  J. Bronstein,et al.  Wilson Disease: An Overview and Approach to Management. , 2020, Neurologic clinics.

[2]  J. Bilezikian,et al.  Signs and Symptoms of Hypoparathyroidism. , 2018, Endocrinology and metabolism clinics of North America.

[3]  S. Khundmiri,et al.  PTH and Vitamin D. , 2016, Comprehensive Physiology.

[4]  E. Brown,et al.  Epidemiology and Diagnosis of Hypoparathyroidism. , 2016, The Journal of clinical endocrinology and metabolism.

[5]  M. Girvent,et al.  Outcome of protracted hypoparathyroidism after total thyroidectomy , 2010, The British journal of surgery.

[6]  D. Shoback.  Clinical practice. Hypoparathyroidism. , 2008, The New England journal of medicine.

[7]  M. Cooper,et al.  CLINICAL REVIEW Diagnosis and management of hypocalcaemia , 2008 .

[8]  K. Kurokawa,et al.  [Calcium regulating hormones and kidney]. , 1986, Nihon Jinzo Gakkai shi.

[9]  J. Kanis,et al.  Rate of reversal of hypercalcaemia and hypercalciuria induced by vitamin D and its 1alpha-hydroxylated derivatives. , 1977, British medical journal.

[10]  Roger DeMordaunt,et al.  Hypoparathyroidism , 1963 .

[11]  M. Höllerhage.  Secondary parkinsonism due to drugs, vascular lesions, tumors, trauma, and other insults. , 2019, International review of neurobiology.