Rare Presentation of Primary Hyperparathyroidism in a Young Woman

Authors

  • Isabel Montenegro Araújo Departamento de Medicina Interna. Hospital Beatriz Ângelo. Loures.
  • Ana Isabel Brochado Departamento de Medicina Interna. Hospital Beatriz Ângelo. Loures.
  • Inês Branco Carvalho Departamento de Medicina Interna. Hospital Beatriz Ângelo. Loures.
  • Sofia Mateus Departamento de Medicina Interna. Hospital CUF Torres Vedras. Torres Vedras.
  • António Martins Baptista Departamento de Medicina Interna. Hospital Beatriz Ângelo. Loures.

DOI:

https://doi.org/10.20344/amp.19616

Keywords:

Bone Diseases/etiology, Hypercalcemia, Hyperparathyroidism, Primary/complications

Abstract

Even though primary hyperparathyroidism (PHPT) is a common endocrine disorder, due to better and more regular screening, the usual presentation is only seen in less than 15% of cases of PHPT. The authors present the case of a young female patient with a previous medical history of depression and nephrolithiasis, with one year of bone pain, that had become progressively worse and disabling. In the initial work-up, several lytic bone lesions and moderate hypercalcemia were found, leading to admission of the patient in the Internal Medicine ward for investigation and treatment. The ensuing investigation revealed PHPT due to hyperfunctioning parathyroid adenoma. The patient underwent a parathyroidectomy and at the follow-up assessment two months after discharge, she reported no symptoms and a computer tomography scan showed regression of the lytic lesions. This case is a reminder that severe symptomatic PHPT, a rare form in developed countries nowadays, still exists, and even though it is a medical condition, collaboration with surgical specialties is necessary to ensure the best possible treatment and prognosis.

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References

Ferraz-de-Sousa B. The evolution of primary hyperparathyroidism. Arch Endocrinol Metab. 2015;59:381-2. DOI: https://doi.org/10.1590/2359-3997000000124

Khan AA, Hanley DA, Rizzoli R, Bollerslev J, Young JE, Rejnmark L, et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensos. Osteoporos Int. 2017,28:1-19. DOI: https://doi.org/10.1007/s00198-016-3716-2

Syed H, Khan A. Primary hyperparathyroidism: diagnosis and management in 2017. Pol Arch Intern Med. 2017;127:438-41. DOI: https://doi.org/10.20452/pamw.4029

Masi, L. Primary hyperparathyroidism. Front Horm Res Basel. 2019,51:1-12. DOI: https://doi.org/10.1159/000491034

Cartwright C, Anastasopoulou C. Hungry bone syndrome. Treasure Island: StatPearls Publishing; 2021.

Makras P, Anastasilakis AD. Bone disease in primary hyperparathyroidism. Metabolism. 2018;79:64-76. DOI: https://doi.org/10.1016/j.metabol.2017.10.003

Walker MD, Silverberg SJ. Primary hyperparathyroidism. Nat Rev Endocrinol. 2018;14:115-25. DOI: https://doi.org/10.1038/nrendo.2017.104

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Published

2023-06-20

How to Cite

1.
Montenegro Araújo I, Brochado AI, Branco Carvalho I, Mateus S, Martins Baptista A. Rare Presentation of Primary Hyperparathyroidism in a Young Woman. Acta Med Port [Internet]. 2023 Jun. 20 [cited 2024 May 28];36(11):746-50. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19616

Issue

Section

Case Report