Fact or Fiction? Psychiatric and Neurocognitive Dysfunction in Patients with Primary Hyperparathyroidism

Rimary Hyperparathyroidism (PHPT) is a disease characterized by elevated serum calcium in the setting of an inappropriately non-suppressed parathyroid hormone level. Classically, patients with PHPT presented with the repercussions of longstanding bone turnover such as osteoporosis, fractures, and nephrolithiasis. Today, many patients with PHPT are discovered incidentally on routine biochemical testing and many lack the classic sequelae of the disease. Instead patients describe psychiatric and neurocognitive dysfunction that may or may not be attributable to their PHPT. In this review we examine the current literature on the non-classical manifestations of PHPT, as well as the evidence for and against early surgical intervention.