Cognitive impairment reversed by cinacalcet administration in primary hyperparathyroidism

Timmons, J.G. , Manners, R., Bailey, M. and McDougall, C. (2021) Cognitive impairment reversed by cinacalcet administration in primary hyperparathyroidism. Hormones, 20(3), pp. 587-589. (doi: 10.1007/s42000-021-00292-4) (PMID:33881757)

Abstract

Primary hyperparathyroidism (pHPT) is a common endocrine disorder. Often serum calcium is minimally elevated with few symptoms. In elderly patients with multiple co-morbidities, the decision to “watch and wait” is often most clinically appropriate as operative intervention is associated with high peri-operative risk. We present an elderly patient with mild hypercalcemia secondary to primary hyperparathyroidism. The clinical decision was initially to watch and wait. The patient subsequently developed cognitive impairment and was diagnosed with mixed Alzheimer’s disease/vascular dementia. She became dependent for all care and housebound. A therapeutic trial of cinacalcet was commenced following a further acute rise in serum calcium. Significant reversal of her functional and cognitive deficit occurred. She was no longer fully dependent. Mini mental state examination (MMSE) improved from 8/30 to 21/30. In vulnerable neural systems, even mild elevation in serum calcium may have a profound effect on cognition and function. We propose a therapeutic trial of cinacalcet in such patients.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Timmons, Dr Joseph
• Authors: Timmons, J.G., Manners, R., Bailey, M., and McDougall, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Hormones
• Publisher: Springer
• ISSN: 1109-3099
• ISSN (Online): 2520-8721
• Published Online: 21 April 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in Hormones 20(3): 587-589
• Publisher Policy: Reproduced under a Creative Commons License