{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:58:07Z","timestamp":1777939087994,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[1998,4,1]],"date-time":"1998-04-01T00:00:00Z","timestamp":891388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of the Royal Society of Health"],"published-print":{"date-parts":[[1998,4]]},"abstract":"<jats:p>The case is presented of a 65 year old lady with recent onset of neuromuscular manifestations, comprising paraparesis, areflexia and unsteady gait, along with episodes of slurring of speech and diplopia, later confirmed to be due to severe hypercalcaemia - which itself was caused by primary hyperparathyroidism. Restoration of normocalcaemia, by means of rehydration and bisphosphonate therapy, resulted in clinical improvement - whilst subsequent parathyroidectomy was followed by complete resolution of all symptoms. In order to make prompt differentiation between the neurological sequelae of hyperparathyroidism and a primary neurological disorder, a high index of suspicion is required. An urgent serum calcium assay, as part of a bone profile, is mandatory in patients who present with neurological symptoms - especially the elderly, amongst whom hyperparathyroidism is especially common.<\/jats:p>","DOI":"10.1177\/146642409811800211","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T13:36:39Z","timestamp":1190122599000},"page":"103-106","source":"Crossref","is-referenced-by-count":2,"title":["Lessons to be learned: a case study approach"],"prefix":"10.1177","volume":"118","author":[{"given":"A.","family":"Olukoga","sequence":"first","affiliation":[{"name":"Chemical Pathology, Department of Clinical Biochemistry, Hope Hospital, Salford, Manchester"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1998,4,1]]},"reference":[{"key":"atypb1","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/S0307-742X(21)00575-0","volume":"12","author":"Bhalla A.K.","year":"1986","journal-title":"Clinics Rheum Dis;"},{"key":"atypb2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00839215"},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1988.tb120508.x"},{"key":"atypb4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1993.tb07468.x"},{"issue":"2","key":"atypb5","doi-asserted-by":"crossref","first-page":"S63","DOI":"10.1002\/jbmr.5650061415","volume":"6","author":"Heath H.","year":"1991","journal-title":"J Bone Miner Res"},{"key":"atypb6","first-page":"275","volume":"37","author":"Heath H.","year":"1991","journal-title":"Adv Intern Med;"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.313.7054.376"},{"key":"atypb8","first-page":"239","volume":"22","author":"Kaplan P.E.","year":"1982","journal-title":"Electromyogr Clin Neurophysiol;"},{"key":"atypb9","volume-title":"Neuromuscular involvement","author":"Ljunghall S.","year":"1984"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1007\/BF00313663"},{"key":"atypb11","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-80-2-182"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.1977.tb04409.x"},{"key":"atypb13","unstructured":"Stewart A.F. and Broadus A.E. (1987). Mineral metabolism. In: Endocrinology and Metabolism , p 1396 (P Felig, J Baxter, A Broadus and L Frohman, eds). New York: McGraw."},{"key":"atypb14","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.1.178"},{"key":"atypb15","first-page":"675","volume":"149","author":"Trigonis C.","year":"1983","journal-title":"Acta Chir Scand;"},{"key":"atypb16","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(89)80613-8"},{"key":"atypb17","first-page":"143","volume":"74","author":"Vicale C.T.","year":"1949","journal-title":"Trans Am Neurol Assoc;"}],"container-title":["Journal of the Royal Society of Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/146642409811800211","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/146642409811800211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:03:00Z","timestamp":1777698180000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/146642409811800211"}},"subtitle":["Primary hyperparathyroidism simulating an acute severe polyneuritis"],"short-title":[],"issued":{"date-parts":[[1998,4]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1998,4]]}},"alternative-id":["10.1177\/146642409811800211"],"URL":"https:\/\/doi.org\/10.1177\/146642409811800211","relation":{},"ISSN":["0264-0325"],"issn-type":[{"value":"0264-0325","type":"print"}],"subject":[],"published":{"date-parts":[[1998,4]]}}}