April 2018 By PsychDB.com

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cl:hypercalcemia-hyperparathyroidism [April 2018]
PsychDB.com [Primer]
cl:hypercalcemia-hyperparathyroidism [April 2018] (current)
PsychDB.com
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 +====== Hypercalcemia and Hyperparathyroidism ======
 +===== Primer =====
 +**Hypercalcemia and hyperparathyroidism** are frequently under-diagnosed in psychiatric practice and there are recommendations that calcium levels should be monitored in patients on long‐term treatment.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​25553494|Shapiro,​ H. I., & Davis, K. A. (2014). Hypercalcemia and “primary” hyperparathyroidism during lithium therapy. American Journal of Psychiatry, 172(1), 12-15.]])] Like with other electrolyte and fluid imbalances (see: [[cl:​hyponatremia|hyponatremia]],​ [[cl:​hypokalemia|hypokalemia]],​ [[cl:​hypomagnesemia|hypomagnesemia]],​ [[cl:​hypocalcemia|hypocalcemia]]),​[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​7220784|Webb Jr, W. L., & Gehi, M. (1981). Electrolyte and fluid imbalance: neuropsychiatric manifestations. Psychosomatics,​ 22(3), 199-203.]])] hypocalcemia can cause neuropsychiatric symptoms.
  
 +===== Signs and Symptoms =====
 +Sequelae of long-term chronic hypercalcemia includes renal stones, osteoporosis,​ dyspepsia, hypertension and renal impairment. Symptoms of hypercalcemia (and consequently hyperparathyroidism) can also mimic as psychiatric disorders, with disturbances of mood, energy, and cognition.
 +
 +
 +===== Pathophysiology =====
 +==== Lithium ====
 +Lithium increases the risk of hypercalcemia and hyperparathyroidism (prevalence of ~5%).[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​22985484|Lehmann,​ S. W., & Lee, J. (2013). Lithium-associated hypercalcemia and hyperparathyroidism in the elderly: What do we know?. Journal of affective disorders, 146(2), 151-157.]])] Up to 10% of patients on long-term lithium treatment develop hypercalcaemia and hyperparathyroidism,​ and this is even higher in the geriatric population.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​22985484|Lehmann,​ S. W., & Lee, J. (2013). Lithium-associated hypercalcemia and hyperparathyroidism in the elderly: What do we know?. Journal of affective disorders, 146(2), 151-157.]])] ​