Hyperparathyroidism as the cause of reversible dementia in the elderly

Abstract

Introduction: dementia is a syndrome characterized by a progressive decline in cognitive and global functions. There are several reversible conditions that may cause it or mimic it. Objectives: to investigate the hyperparathyroidism (HPT) as the cause of dementia and their potential reversibility. Methods: clinical and laboratory evaluation of 60 elderly people with suspected dementia referred to the Affonso Silviano Brandao Outpatient Ambulatory at the Medical Sciences College of Minas Gerais and Sao Jose University Hospital - Belo Horizonte. The total serum calcium, 25-hydroxyvitamin D, and parathyroid hormone (PTH) in the diagnosis were 12.4, and 13.2 mg/dL; 14 and 10 ng/mL; and 227 and 302 pg/ml, respectively. Results: The mean age was 73 ± 8 years; 70% female; including two patients with high levels of calcium and PTH and low levels of vitamin D. They also presented low kidney stones, changes in cognitive function, depressive symptoms, osteoporosis with fractures, and visible lump in cervical region ultrasound, and hypercaptant to Sestamibi-99mTc by scintigraphy. The probable cause of HPT, epidemiologically, was an adenoma. Once the diagnosis was confirmed, we opted for surgical treatment through a minimally invasive technique, with intraoperative PTH monitoring (PTH-IO). These patients underwent pre and