Abstract
Key Clinical MessageWhen you see a patient with cognitive dysfunction, hypercalcemia due to hyperparathyroidism is an important differential diagnosis. It is important to consider including chest computed tomography and 131I‐MIBI SPECT examinations in patients with possible hyperparathyroidism and normal thyroid ultrasound.
Highlights
A 77‐year‐old woman presented to our hospital with progressive cognitive decline
Laboratory tests were significant for corrected calcium of 12.3 mg/dL reference, phosphate of 2.4 mg/dL, and elevated intact parathyroid hormone of 549 pg/mL
Contrast enhanced CT demonstrated a well‐defined enhancing mass (Figure 1A, yellow arrow). 131I‐methoxyisobutyl isonitrile (MIBI) single‐photon emission computed tomography SPECT) showed specific uptake in the mass (Figure 1B, arrowheads). Because her cognitive impairment was persistent despite the administration of calcitonin plus normal saline infusion, she underwent surgical resection of ectopic mediastinal parathyroid adenoma
Summary
A 77‐year‐old woman presented to our hospital with progressive cognitive decline. Laboratory tests were significant for corrected calcium of 12.3 mg/dL reference (range: 8.8‐10.1 mg/dL), phosphate of 2.4 mg/dL (range: 2.7‐4.6 mg/dL), and elevated intact parathyroid hormone of 549 pg/mL (range: 10‐65 pg/mL). KEYWORDS 131I‐MIBI, ectopic parathyroid adenoma, hypercalcemia, hyperparathyroidism A 77‐year‐old woman presented to our hospital with progressive cognitive decline.
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