{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:53:01Z","timestamp":1753883581050,"version":"3.41.2"},"reference-count":10,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Posterior reversible encephalopathy syndrome (PRES) represents a distinct neurological entity characterized by a range of neurological signs and symptoms (seizures, headache, visual abnormalities, altered consciousness, and\/or focal neurological signs) and typical neuroimaging findings reflecting reversible subcortical vasogenic edema, usually in the setting of blood pressure fluctuations, cytotoxic drugs, autoimmune disorders, and eclampsia. Here we present a case of a 61-year-old woman, with a history of recent total thyroidectomy and postoperative hypoparathyroidism, who was admitted to the Emergency Department with generalized seizures. Although in this clinical setting, hypocalcemia is expected as the most possible underlying pathogenic factor for triggering seizures, the patient was diagnosed with iatrogenic hypercalcemia and milk-alkali syndrome. A brain magnetic resonance imaging (MRI) demonstrated cortical swelling and fluid-attenuated inversion recovery (FLAIR) signal abnormalities in both occipital, parietal, and right frontal lobes, consistent with PRES. The patient\u2019s encephalopathy resolved after resolution of hypercalcemia; she had no neurological deficits on discharge, while she was restarted on lower doses of calcium for hypoparathyroidism. This case illustrates the challenges imposed by postoperative hypoparathyroidism and highlights that PRES is a rare but serious complication of hypercalcemia of which endocrinologists should be aware.<\/jats:p>","DOI":"10.1210\/jcemcr\/luad116","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T15:50:08Z","timestamp":1695657008000},"source":"Crossref","is-referenced-by-count":1,"title":["Post-Thyroidectomy Development of Posterior Reversible Encephalopathy Syndrome (PRES) Due to Calcium Over-Replacement"],"prefix":"10.1210","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9853-493X","authenticated-orcid":false,"given":"Olga","family":"Papalou","sequence":"first","affiliation":[{"name":"Department of Endocrinology Diabetes and Metabolism, National Expertise Center for Rare Endocrine Disorders, Evangelismos Hospital , Athens 10676 , Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8129-2564","authenticated-orcid":false,"given":"Ekaterini","family":"Tavernaraki","sequence":"additional","affiliation":[{"name":"Department of Radiology, Evangelismos Hospital , Athens 10676 , Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1959-8738","authenticated-orcid":false,"given":"Stylianos","family":"Tsagarakis","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Diabetes and Metabolism, National Expertise Center for Rare Endocrine Disorders, Evangelismos Hospital , Athens 10676 , Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3403-8977","authenticated-orcid":false,"given":"Dimitra Argyro","family":"Vassiliadi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Diabetes and Metabolism, National Expertise Center for Rare Endocrine Disorders, Evangelismos Hospital , Athens 10676 , Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2023,9,25]]},"reference":[{"issue":"8","key":"2023102813275394500_luad116-B1","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1056\/NEJM199602223340803","article-title":"A reversible posterior leukoencephalopathy syndrome","volume":"334","author":"Hinchey","year":"1996","journal-title":"N Engl J Med"},{"issue":"9","key":"2023102813275394500_luad116-B2","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/S1474-4422(15)00111-8","article-title":"Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions","volume":"14","author":"Fugate","year":"2015","journal-title":"Lancet Neurol"},{"issue":"8","key":"2023102813275394500_luad116-B3","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1007\/s00415-016-8377-8","article-title":"Posterior reversible encephalopathy syndrome","volume":"264","author":"Fischer","year":"2017","journal-title":"J Neurol"},{"issue":"2","key":"2023102813275394500_luad116-B4","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2017-223415","article-title":"Posterior reversible encephalopathy syndrome due to hypercalcaemia: a rare cause","volume":"12","author":"Bolanthakodi","year":"2019","journal-title":"BMJ Case Rep"},{"issue":"6","key":"2023102813275394500_luad116-B5","doi-asserted-by":"crossref","first-page":"338","DOI":"10.20344\/amp.9714","article-title":"Posterior reversible encephalopathy syndrome: a case of hypercalcemia","volume":"31","author":"Ponciano","year":"2018","journal-title":"Acta Med Port"},{"key":"2023102813275394500_luad116-B6","doi-asserted-by":"crossref","first-page":"100278","DOI":"10.1016\/j.bonr.2020.100278","article-title":"A 39 year-old woman with milk-alkali syndrome complicated by posterior reversible encephalopathy syndrome","volume":"12","author":"Vu","year":"2020","journal-title":"Bone Rep"},{"key":"2023102813275394500_luad116-B7","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jns.2019.07.018","article-title":"Posterior reversible encephalopathy syndrome: a review with emphasis on neuroimaging characteristics","volume":"404","author":"Tetsuka","year":"2019","journal-title":"J Neurol Sci"},{"issue":"3","key":"2023102813275394500_luad116-B8","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.ajpath.2019.11.004","article-title":"Endothelial cell calcium signaling during barrier function and inflammation","volume":"190","author":"Dalal","year":"2020","journal-title":"Am J 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