Depressive Disorder in Primary Hyperparathyroidism and Effects of Surgery in Elderly Patients: Case Series
Journal Title: International Journal of Surgery & Surgical Techniques - Year 2024, Vol 8, Issue 1
Abstract
Background: Patients with primary hyperparathyroidism (PHPT) often present nonspecific symptoms such as major depressive disorder and psychosis. Calcium plays a role in the pathogenesis of psychiatric symptoms by determining changes in monoamine metabolism in the central nervous system, thereby modifying neurotransmission and resulting in mood and cognitive alterations. Case series: This report presents a case series of 3 patients; 70-year-old, 78 year- old and 94 year-old women with PHPT and severe depression symptoms and its response to parathyroidectomy. The patients were a poor historian. Results of preoperative laboratory tests showed an increased serum calcium level (11.15mg/dL, 10.9 mg/dL and 11.4 mg/dL- reference range 8.4-10.2 mg/dL). A repeat serum calcium test confirmed hypercalcemia with concurrent elevated intact parathyroid hormone level. Two patients were undergone at parathyroidectomy. A 94 year-old patient refuse surgical approach and was efficacy treated with a single dose of zoledronic acid. Therefore, the patients underwent parathyroidectomy two months after procedure had a clinical improvement on depressive symptoms. There was any recurrent laryngeal nerve injury or recurrent PHTP. Conclusion: The presence of a long-standing depressive disorder unresponsive to medical therapy may suggest an organic disorder such as chronic hypercalcemia which may be secondary to PHPT. Surgical intervention in these selected cases can assist medical therapy in the improvement of depressive symptoms.
Authors and Affiliations
Sanna A*, Buzzi G, Prando D, Targa S, Bagolini F, Mantovan B, Zuliani L and Mazza A
Keywords
Related Articles
- EP ID EP748556
- DOI 10.23880/ijsst-16000208
- Views 51
- Downloads 0
The Impact of COVID-19 Pandemic on Medical Education in a Sub- Saharan African Country (Kenya)
In 2019 the World was faced with a new infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), the corona virus disease 2019 (COVID-19). The disease was first reported in China...
Application of Platelet-Rich Plasma in Nasal Tip Reconstruction with Medpor Prosthesis
Objective: To observe the effect of platelet-rich plasma (PRP) on reducing ear cartilage absorption and nasal tip complications after nasal tip plasty with medpor prosthesis. Methods: During the conventional medpor rhi...
Aorto-Caval Fistula Following an Abdominal Infrarenal Aneurysm Rupture
Abdominal aortic aneurysms are a chronic dilation of the aorta with a natural history toward enlargement and rupture. It’s a substantial burden on health care. Their incidence has increased during the past two decades,...
Depressive Disorder in Primary Hyperparathyroidism and Effects of Surgery in Elderly Patients: Case Series
Background: Patients with primary hyperparathyroidism (PHPT) often present nonspecific symptoms such as major depressive disorder and psychosis. Calcium plays a role in the pathogenesis of psychiatric symptoms by determ...
Basal Cell Carcinoma of the Prostate: Case Reports Including an Unusual Presentation
Basal cell carcinoma of the prostate is a rare tumor subtype arising from the prostatic basal cells and follows a variable clinical course. We describe two cases of patients with basal cell carcinoma of the prostate tre...