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Psychological and Behavioral Abnormalities as the Initial Manifestation of Idiopathic Hypoparathyroidism: A Case Report

Author(s): Pingping Ning, Xinglong Yang, Quanzhen Zhao, Hongyan Huang, Ran An, Yalan Chen, Yanming Xu


Background: Idiopathic hypoparathyroidism is a rare endocrine disorder typically manifesting as paresthesias of the extremities and perioral region, muscle cramps, capopedal spasms, tetany, seizure, and fatigue. The condition is not known to manifest initially as psychological and behavioral abnormalities.

Case presentation: We report the case of a 53-year-old Chinese woman who presented with symptoms of depression, anxiety, feelings of agitation, irritability, hyperhidrosis, slow action and decreased interest in most activities. Computed tomography of the brain revealed intracranial calcification, scores on the Hamilton Anxiety Scale and Hamilton Depression Scale showed that she suffered from depression and anxiety, and scores on the Minimum Mental State Examination and Montreal Cognitive Assessment revealed impaired cognitive function. Laboratory analyses showed hypocalcemia, hyperphosphatemia and parathyroid hormone deficiency. Calcium carbonate and vitamin D3 supplementation therapy improved the patient’s clinical symptoms of depression and anxiety, as well as her levels of calcium and phosphate. However, this treatment did not substantially improve
the level of parathyroid hormone or reduce cognitive impairment.

Conclusions: Idiopathic hypoparathyroidism can manifest initially as psychological and behavioral abnormalities, which clinicians should keep in mind.

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