Case Report Neuropsychiatric presentation following Teriparatide treatment causing altered sensorium: Neuropsychiatric presentation following Teriparatide treatment
Authors
Nitin Rathod, ANDREA JANICE FONSECA, Dr Siddharath SoniFiles
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Journal
Published in Vol. 66 No. 3 (2024) of Bombay Hospital Journal.
Bombay Hospital Journal (BHJ) is a peer-reviewed quarterly published Print and Online journal. It is an official Journal of Bombay Hospital institute of medical sciences. The aim of BHJ is to improve medical care by publishing sound scientific articles (both research and practice papers) and focusing on topics that are of great importance to its readership.
Editor-in-Chief- Dr Satish Vasant Khadilkar
About the JournalAbstract
Aim- Neuropsychiatric presentation following Teriparatide treatment causing altered sensorium
Background- Patient with a history of osteoporosis on Inj Teriparatide daily for the last two months were recently operated for Minimally invasive L3-L4 decompression and L3-L5 percutaneous fixation with L4 vertebroplasty
Case Description-63 Yrs old postmenopausal female women, who presented with dizziness, increased thirst, constipation and persistent drowsiness. Patient was found to have hypercalcemia (13.5 mg%).MRI and CSF examination were inconclusive.PET scan was performed to rule out multiple myeloma and any underlying malignancies.Serum protein electrophoresis was normal.
Conclusion- As patient was on regular Teriparatide treatment it was considered as the cause of her raised calcium levels. Patient responded to bisphosphonate therapy, hydration and calcitonin. After 48 hours of treatment , the patient's serum calcium levels returned to normal and patient improved.
Clinical significance- Patients who are on regular treatment of Teriparatide should be closely monitored for hypercalcemia and evaluated for the symptoms related to it.
References
REFERENCES:
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Sundriyal D, Arya L, Saha R, Walia M, Nayak PP. Hypercalcemia of Malignancy: Time to Pull the Brakes. Indian J Surg Oncol. 2022 Mar;13(1):28-32.
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McCarroll K, Carroll T, Neville M, Fitzpatrick D, Lannon R. Delayed and significant hypercalcaemia due to teriparatide therapy: a case report and review. Osteoporos Int. 2024 Jul;35(7):1299-1302
Reisian S, Bonakdaran S, Moradi A, Yaghoubi MA. Teriparatide-induced Sever Persistent Hypercalcemia in an Osteoporotic Patient: A Case Report and Literature Review. Arch Bone Jt Surg. 2025;13(3):170-175
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