Life-threatening Hypercalcaemic Crisis Due to Benign Primary Hyperparathyroidism, a Case Report

Abstract

Primary Hyperparathyroidism (PHPT) is a frequent cause of hypercalcaemia and parathyroid adenoma is the most frequent aetiology. Most patients are now diagnosed incidentally or with slightly symptomatic disease, however PHPT can cause extremely elevated calcium levels leading to hypercalcaemic crisis, a life-threatening clinical scenario associated with calcium-related organ failure. We present a case of a woman with long-lasting neuropsychiatric symptoms caused by PHPT, misdiagnosed as a depressive syndrome, which ultimately develops hypercalcaemic crisis. After parathyroidectomy, patient fully recovered organ failure and previous depressive symptoms within six months. Early diagnosis, adequate resuscitation and organ support associated with parathyroidectomy can lead to a better prognosis in comparison with the elevated mortality reported in the past.