Case Report Neuropsychiatric presentation following Teriparatide treatment causing altered sensorium
Neuropsychiatric presentation following Teriparatide treatment
DOI:
https://doi.org/10.15713/ins.bhj.183Keywords:
Hypercalcemia, MRI SPINE, PET CT, CalcitoninAbstract
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
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