A 53‐year‐old man without history of mental disorders has a history of ESRD‐induced uremia and has received continuous ambulatory peritoneal dialysis (CAPD) since September 2012. Secondary hyperparathyroidism was diagnosed three months after dialysis. Phosphorus intake was restricted and he received calcitriol but was discontinued in January 2016 due to aggravated hyperphosphatemia. Parathyroid hormone (PTH) elevated to 1,600.06 pg/mL (reference range: 10.00‐60.00 pg/mL) and ultrasonography revealed four enlarged parathyroid glands and mild goiter. Blood examination showed abnormal serum phosphorus 8.7 mg/dL (reference range: 2.7‐4.5 mg/dL) and calcium 10.6 mg/dL (reference range: 8.9‐10.3 mg/dL). Total parathyroidectomy and parathyroid autotransplantation were performed in March 2019, and histopathological findings demonstrated parathyroid hyperplasia. After surgery, PTH level reduced to 12.44 pg/mL in two days. Calcium carbonate, up to 1500mg QID PO, was administered but serum calcium level decreased rapidly to 6.1 mg/dL in three days. Despite mild general weakness, the patient was discharged the next morning.

中文翻译：

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甲状旁腺切除术后低钙血症相关的躁狂症。

一名无精神病史的53岁男性，有ESRD引起的尿毒症病史，自2012年9月起接受连续性非卧床腹膜透析（CAPD）。透析后三个月诊断为继发性甲状旁腺功能亢进。磷摄入受到限制，他接受了骨化三醇，但由于高磷血症加重，于2016年1月停药。甲状旁腺激素（PTH）升高至1,600.06 pg / mL（参考范围：10.00-60.00 pg / mL），超声检查发现四个甲状旁腺肿大和轻度甲状腺肿。血液检查显示血清磷异常8.7 mg / dL（参考范围：2.7-4.5 mg / dL）和钙10.6 mg / dL（参考范围：8.9-10.3 mg / dL）。于2019年3月进行了甲状旁腺全切除术和甲状旁腺自体移植，组织病理学检查结果显示甲状旁腺增生。手术后，PTH水平在两天内降至12.44 pg / mL。施用碳酸钙，QID PO高达1500mg，但三天内血清钙水平迅速下降至6.1mg / dL。尽管全身无力，但第二天早晨该病人已出院。