Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This report describes a case of primary hyperparathyroidism in a 68-year-old man. The endocrine disorder, while suspected before the commission of homicide and attempted murder, was proven biochemically and histologically a number of months after the commission of the crimes. The acts of homicide and attempted murder followed the development of paranoid delusions, which rapidly resolved upon successful removal of a single cystic parathyroid gland adenoma. The unusual events that immediately followed the acts of violence indicate that the delusions occurred in a clear sensorium (absence of delirium). Psychological measures taken before and after surgery document improvement in subtle organic functioning while intelligence was unchanged. This report discusses the neuropsychiatric manifestations of hypercalcemia and reviews the literature.
 ...
PMID:Primary hyperparathyroidism, hypercalcemia, paranoid delusions, homicide, and attempted murder. 366 84

A 67-year-old woman who had primary hyperparathyroidism presented with delirium rather than dementia as the predominant psychologic manifestation. After surgical removal of a parathyroid adenoma, there was a dramatic improvement in mental status. Psychologic retesting at six weeks after discharge showed her to be well oriented to time, place, and person, with no impairment of cognitive capacity.
 ...
PMID:Delirium as the predominant manifestation of hyperparathyroidism: reversal after parathyroidectomy. 647 Mar 89

The authors report the case of a woman with borderline personality disorder who developed a prolactinoma probably induced by amisulpride. This patient was treated with 300 mg of amisulpride per day for a delirium. Her brain MRI was normal. Four months later this patient developed a micro-adenoma (5mm) on the right side of the pituitary gland with amenorrhea and galactorrhea. Amisulpride treatment was withdrawn and replaced by a treatment of quetiapine 100 mg day(-1). The hyperprolactinemia symptoms disappeared. This report shows that the short-term use of amisulpride treatment was linked to an elevation in the PRL level with a possible induction of a pituitary adenoma.
 ...
PMID:A possible effect of amisulpride on a prolactinoma growth in a woman with borderline personality disorder. 1522 84

Hyperparathyroid crisis is an uncommon clinical state characterized by severe hypercalcemia which can produce an acute confusional syndrome (ACS) or delirium. We are reporting the case of a 58-year male with calcemias greater than 14 mg/dl, that were due to a parathyroid adenoma (primary hyperparathyroidism), and caused his admission in UCI with change in the conscience level, global afectation of the cognitive functions, letargia and disorentiation among other clinical symptoms. The patient was operated by our Service on lower left parathyroidectomy with PTH rapid or turbo assay and decreasing such hormone levels about 75%. After the surgery his evolution was satisfactory obtaining the normocalcemia.
 ...
PMID:[Acute confusional syndrome as first manifestation of primary hyperparathyroidism]. 1556 60

Lithium-associated hyperparathyroidism is the leading cause of hypercalcemia in lithium-treated patients. Lithium may lead to exacerbation of pre-existing primary hyperparathyroidism or cause an increased set-point of calcium for parathyroid hormone suppression, leading to parathyroid hyperplasia. Lithium may cause renal tubular concentration defects directly by the development of nephrogenic diabetes insipidus or indirectly by the effects of hypercalcemia. In this study, we present a female patient on long-term lithium treatment who was evaluated for hypercalcemia. Preoperative imaging studies indicated parathyroid adenoma and multinodular goiter. Parathyroidectomy and thyroidectomy were planned. During the postoperative course, prolonged intubation was necessary because of agitation and delirium. During this period, polyuria, severe dehydration, and hypernatremia developed, which responded to controlled hypotonic fluid infusions and was unresponsive to parenteral desmopressin. A diagnosis of nephrogenic diabetes insipidus was apparent. A parathyroid adenoma and multifocal papillary thyroid cancer were detected on histopathological examination. It was thought that nephrogenic diabetes insipidus was masked by hypercalcemia preoperatively. A patient on lithium treatment should be carefully followed up during or after surgery to prevent life-threatening complications of previously unrecognized nephrogenic diabetes insipidus, and the possibility of renal concentrating defects on long-term lithium use should be sought, particularly in patients with impaired consciousness.
...
PMID:Lithium-associated primary hyperparathyroidism complicated by nephrogenic diabetes insipidus. 2650 22

Hypercalcemia is known to cause neuropsychiatric dysfunction including mood and cognitive changes and rarely, acute psychosis. High calcium levels can be a catalyst for neuronal demise, possibly due to glutaminergic excitotoxicity and dopaminergic and serotonergic dysfunction. While restoration of normal calcium levels or removal of a parathyroid adenoma has been shown to rapidly resolve neuropsychiatric symptoms, there have been rare reported cases of primary hyperparathyroid-related hypercalcemia with persistent symptoms of psychosis. In this case report, we will describe a patient with no past psychiatric history presenting with a protracted course of delirium and psychosis after a removal of a parathyroid adenoma which had caused prolonged exposure to hypercalcemia. The patient's psychosis was unresponsive to psychotropic medication and required inpatient psychiatric care after medical clearance. Per medical records, before the patient was ultimately lost to follow-up, she continued to suffer from psychotic symptoms for at least 8 months. We will discuss the patient's unusual hospital course and management and offer suggestions for future study.
 ...
PMID:Prolonged Hypercalcemia-Induced Psychosis. 3209 11