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Unmasking normocalcaemic hyperparathyroidism (nPHPT) resulting in severe hypercalcaemia from lack of monitoring during in the COVID pandemic

MOJ Gerontology & Geriatrics
Peter Chua,Su-Lee Xiao, Elaine Hui,3  YetundeBaoku, Eddy Chua2


Primary hyperparathyroidism (PHPT) is a common endocrine disorder in the older person although the incidence of normocalcaemic primary hyperparathyroidism (nPHPT) remains largely unknown. Whilst the majority of patients with PHPT asymptomatic, we describe a case of severe symptomatic hypercalcaemia from undiagnosed nPHPT whilst on calcium and vitamin D supplements. This is an important reminder to clinicians that serum calcium should be monitored before and after initiation of calcium and vitamin D supplementation in the older person.


primary hyperparathyroidism, normocalcaemic primary hyperparathyroidism ,calcium and vitamin d supplements, older people, hypoactive delirium, bisphosphonate therapy, excluded myeloma, biphasic circadianrhythm, tubular reabsorption, older person