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Case Reports in Endocrinology
Volume 2014, Article ID 937631, 4 pages
http://dx.doi.org/10.1155/2014/937631
Case Report

A Case of Acute Psychosis in an Adolescent Male

1Section of Pediatric Endocrinology, Children’s Mercy Hospitals and Clinics, 3101 Broadway Boulevard, Kansas City, MO 64111, USA
2Division of Pediatric Endocrinology, University of Illinois College of Medicine at Chicago, 1853 W. Polk Street, Chicago, IL 60612, USA

Received 6 December 2013; Accepted 5 February 2014; Published 30 March 2014

Academic Editors: C. Capella and A. J. O’Sullivan

Copyright © 2014 Ghufran Babar and Ramin Alemzadeh. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Primary hyperparathyroidism (PHPT) is a disorder of calcium homeostasis. We report the case of a 17-year-old adolescent male, who presented with an acute psychosis coinciding with severe hypercalcemia and markedly elevated intact parathyroid hormone (iPTH) level and low vitamin D level. A Sestamibi scan showed a positive signal inferior to the left lobe of the thyroid gland. He had only a partial response to the initial medical and psychiatric management. The enlarged parathyroid gland was resected surgically and postoperatively serum calcium and iPTH levels normalized. The histopathology was compatible with a benign adenoma. Patient’s acute psychotic symptoms resolved gradually after surgery; however he remained under psychiatric care for the behavioral issues for about 6 months after surgery. While psychosis is a rare clinical manifestation of hypercalcemia secondary to PHPT in pediatric population, it should be considered as a clinical clue in an otherwise asymptomatic pediatric patient.