Severe Neuropsychiatric Symptoms Associated with "Mild" Primary Hyperparathyroidism: A Case Report

Neuropsychiatric manifestations are a well-known complication of primary hyperparathyroidism (PHPT) yet are often overlooked in patients with mild hypercalcemia [1]. Parathyroidectomy solely for the treatment of neuropsychiatric symptoms or signs of PHPT remains controversial [2]. We, herein, describe the case of a 66-year-old previously healthy woman with several months of severe depressive symptoms, including anhedonia, catatonia, hallucinations, and poor oral intake who was diagnosed with mild PHPT. After an extensive negative extensive workup for other causes of her neuropsychiatric symptoms, she underwent parathyroidectomy with a dramatic improvement in her symptoms shortly after surgery.