Skip to main content
Book cover

Surgery pp 127–137Cite as

Fatigue, Constipation, and Depressed Mood

  • 3161 Accesses

Abstract

A 62-year-old woman presents to your office after being diagnosed with osteoporosis by her primary care physician. Her T-score is −4.2 at the lumbar spine. Further testing reveals a serum calcium level of 11 mg/dL (normal 8.5–10.5 mg/dL), phosphate level of 1.7 mg/dL (2.5–4.8 mg/dL), intact parathyroid hormone level of 83 pg/mL (15–75 pg/mL), and elevated urinary calcium levels. She denies any previous fractures. She reports fatigue and has more difficulty concentrating than before. She denies any history of neck irradiation or family history of thyroid or parathyroid disease. She has no significant past medical or surgical history. She has no known allergies. She occasionally takes ibuprofen for joint pain in her hands. She is a retired schoolteacher who is physically active and enjoys traveling. On review of systems, the patient reports constipation and occasional depressed mood. Physical examination demonstrates a healthy adult female; her neck is supple without masses or adenopathy.

Keywords

  • Hyperparathyroid
  • Calcium
  • PTH
  • Nephrolithiasis
  • Hypercalcemia
  • Hypercalcemic crisis
  • Chvostek’s sign
  • MEN
  • Parathyroidectomy
  • Hungry bone syndrome

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-030-05387-1_12
  • Chapter length: 11 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   39.99
Price excludes VAT (USA)
  • ISBN: 978-3-030-05387-1
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Hardcover Book
USD   49.99
Price excludes VAT (USA)
Fig. 12.1
Fig. 12.2
Fig. 12.3
Fig. 12.4

Suggested Reading

  • Bilezikian JP, et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the fourth international workshop. J Clin Endocrinol Metab. 2014;99(10):3561–9.

    CAS  CrossRef  Google Scholar 

  • Li S, et al. Trends in parathyroidectomy rates in US hemodialysis patients from 1992 to 2007. Am J Kidney Dis. 2011;57(4):602–11.

    CrossRef  Google Scholar 

  • Schneider DF, et al. Predictors of recurrence in primary hyperparathyroidism: an analysis of 1386 cases. Ann Surg. 2014;259(3):563–8.

    CrossRef  Google Scholar 

  • Stewart AF. Clinical practice. Hypercalcemia associated with cancer. N Engl J Med. 2005;352(4):373–9.

    CAS  CrossRef  Google Scholar 

  • Wilheim SM, et al. The American Association of Endocrine Surgeons Guidelines for definitive management of primary hyperparathyroidism. JAMA Surg. 2016;151(10):959–68.

    CrossRef  Google Scholar 

  • Yeh MW, et al. Surgery for primary hyperparathyroidism: are the consensus guidelines being followed? Ann Surg. 2012;255(6):1179–83.

    CrossRef  Google Scholar 

  • Yeh MW, et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab. 2013;98(3):1122–9.

    CAS  CrossRef  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James X. Wu .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Verify currency and authenticity via CrossMark

Cite this chapter

Wu, J.X., Frank, P.N., Yeh, M.W. (2020). Fatigue, Constipation, and Depressed Mood. In: de Virgilio, C., Grigorian, A. (eds) Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-05387-1_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-05387-1_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-05386-4

  • Online ISBN: 978-3-030-05387-1

  • eBook Packages: MedicineMedicine (R0)