Hypercalcemic Encephalopathy due to Ectopic Parathyroid Adenoma in an Elderly Woman
Hypercalcemia leads to serious neurological manifestations due to the modulation of neurotransmitters by high calcium levels. Hypercalcemia secondary to primary hyperparathyroidism attributable to an ectopic parathyroid adenoma is a rare clinical entity. The exact localization of the ectopic lesion...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-04-01
|
| Series: | Journal of the Indian Academy of Geriatrics |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/jiag.jiag_27_25 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849709260073598976 |
|---|---|
| author | Parth Sharma Monica Gupta Ambadas Rathod Puneet Kaur Sudhansoo Khanna |
| author_facet | Parth Sharma Monica Gupta Ambadas Rathod Puneet Kaur Sudhansoo Khanna |
| author_sort | Parth Sharma |
| collection | DOAJ |
| description | Hypercalcemia leads to serious neurological manifestations due to the modulation of neurotransmitters by high calcium levels. Hypercalcemia secondary to primary hyperparathyroidism attributable to an ectopic parathyroid adenoma is a rare clinical entity. The exact localization of the ectopic lesion can be challenging for clinicians, requiring a multimodal approach. An elderly female presented to our emergency department in an irritable state, followed by altered consciousness. The serum calcium, phosphorus, and serum intact parathormone levels were >14 mg/dL, 2.3 mg/dL, and 428 pg/mL, respectively. After a series of investigations, technetium-99m sestamibi parathyroid scintigraphy clinched the diagnosis of a MIBI-avid lesion, a 19 mm × 14 mm × 23 mm parathyroid adenoma at the T2–T3 vertebral level, anteromedial to the left common carotid artery. The high calcium levels were initially managed with aggressive fluid resuscitation with intravenous normal saline. This was followed by complete excision of the parathyroid adenoma. Our case report highlights the importance of an early identification of potentially reversible etiologies of hypercalcemia and elucidates an approach to physicians regarding hypercalcemic encephalopathy. |
| format | Article |
| id | doaj-art-bcbc2768ae8449aba07ef3a0f6c4aeb4 |
| institution | DOAJ |
| issn | 0974-3405 0974-2484 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of the Indian Academy of Geriatrics |
| spelling | doaj-art-bcbc2768ae8449aba07ef3a0f6c4aeb42025-08-20T03:15:22ZengWolters Kluwer Medknow PublicationsJournal of the Indian Academy of Geriatrics0974-34050974-24842025-04-0121215515810.4103/jiag.jiag_27_25Hypercalcemic Encephalopathy due to Ectopic Parathyroid Adenoma in an Elderly WomanParth SharmaMonica GuptaAmbadas RathodPuneet KaurSudhansoo KhannaHypercalcemia leads to serious neurological manifestations due to the modulation of neurotransmitters by high calcium levels. Hypercalcemia secondary to primary hyperparathyroidism attributable to an ectopic parathyroid adenoma is a rare clinical entity. The exact localization of the ectopic lesion can be challenging for clinicians, requiring a multimodal approach. An elderly female presented to our emergency department in an irritable state, followed by altered consciousness. The serum calcium, phosphorus, and serum intact parathormone levels were >14 mg/dL, 2.3 mg/dL, and 428 pg/mL, respectively. After a series of investigations, technetium-99m sestamibi parathyroid scintigraphy clinched the diagnosis of a MIBI-avid lesion, a 19 mm × 14 mm × 23 mm parathyroid adenoma at the T2–T3 vertebral level, anteromedial to the left common carotid artery. The high calcium levels were initially managed with aggressive fluid resuscitation with intravenous normal saline. This was followed by complete excision of the parathyroid adenoma. Our case report highlights the importance of an early identification of potentially reversible etiologies of hypercalcemia and elucidates an approach to physicians regarding hypercalcemic encephalopathy.https://journals.lww.com/10.4103/jiag.jiag_27_25ectopic parathyroid adenomahypercalcemiaprimary hyperparathyroidismsestamibi parathyroid scintigraphy |
| spellingShingle | Parth Sharma Monica Gupta Ambadas Rathod Puneet Kaur Sudhansoo Khanna Hypercalcemic Encephalopathy due to Ectopic Parathyroid Adenoma in an Elderly Woman Journal of the Indian Academy of Geriatrics ectopic parathyroid adenoma hypercalcemia primary hyperparathyroidism sestamibi parathyroid scintigraphy |
| title | Hypercalcemic Encephalopathy due to Ectopic Parathyroid Adenoma in an Elderly Woman |
| title_full | Hypercalcemic Encephalopathy due to Ectopic Parathyroid Adenoma in an Elderly Woman |
| title_fullStr | Hypercalcemic Encephalopathy due to Ectopic Parathyroid Adenoma in an Elderly Woman |
| title_full_unstemmed | Hypercalcemic Encephalopathy due to Ectopic Parathyroid Adenoma in an Elderly Woman |
| title_short | Hypercalcemic Encephalopathy due to Ectopic Parathyroid Adenoma in an Elderly Woman |
| title_sort | hypercalcemic encephalopathy due to ectopic parathyroid adenoma in an elderly woman |
| topic | ectopic parathyroid adenoma hypercalcemia primary hyperparathyroidism sestamibi parathyroid scintigraphy |
| url | https://journals.lww.com/10.4103/jiag.jiag_27_25 |
| work_keys_str_mv | AT parthsharma hypercalcemicencephalopathyduetoectopicparathyroidadenomainanelderlywoman AT monicagupta hypercalcemicencephalopathyduetoectopicparathyroidadenomainanelderlywoman AT ambadasrathod hypercalcemicencephalopathyduetoectopicparathyroidadenomainanelderlywoman AT puneetkaur hypercalcemicencephalopathyduetoectopicparathyroidadenomainanelderlywoman AT sudhansookhanna hypercalcemicencephalopathyduetoectopicparathyroidadenomainanelderlywoman |