Endocrine Abstracts (2006) 11 P149

Psychiatric and movement disorders in primary hypoparathyroidism

S Chatterjee

Vivekananda Institute of Medical Sciences, University of Calcutta, Calcutta, India.

Described here is a series of 3 patients with psychiatric disorders and 4 patients with movement disorders associated with primary hypoparathyroidism. Patients of ages 18 through 55 years and were seen 1998–2004 in a general hospital. Institutional Ethical Committee approval was obtained for the study.

On presentation, all patients had fasting plasma tested for calcium, magnesium, phosphorus, albumin and intact PTH. All had CT scans of the head. All had low calcium (mean: 1.41±0.15 mmol/l) and iPTH (mean: 7.3 pg/ml, normal range: 11.1–79.5 pg/ml) and were on inadequate treatment when seen. Treatment with oral calcium and calcitriol normailsed calcium in 10–30 days.

Patients with psychiatric disorders: Patient 1, a 25 yr male had schizophrenia; Patient 2, an 18 yr woman, initially had acute psychosis and later stabilised to an organic delusional disorder; Patient 3, a 29 yr male had bipolar disorder. All had convulsions as well. Normalisation of calcium did not improve the psychiatric condition in any patient.

Patients with movement disorders: Patient 4, a 50 yr female had dementia and dystonia. Dystonia improved on treatment. Patient 5, a 42 yr female had dystonia, orofaciolingual dyskinesia and ballismus. Only mild dystonia persisted after treatment. Patient 6, a 55 yr female had a 10-day history of chorea and a 4-day history of seizures. Both completely disappeared on treatment. Patient 7, a 48 yr male had choreoathetosis for 6 months. It completely disappeared on treatment.

Conclusion: In primary hypoparathyroidism, psychiatric disorders did not improve but movement disorders markedly improved on correction of hypocalcemia.

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