IJCRR - vol 06 issue 01, January, 2014
PRIMARY HYPERPARATHYROIDISM DUE TO BILATERAL PARATHYROID ADENOMA - A CLINICAL CASE REPORT
Author: Mousumi Mukhopadhyay, Sharmistha Chattopadhay, Sanghamitra Chakraborty, Swati Bhattacharyya, Soumika Biswas
Primary hyperparathyroidism is known by inappropriate secretion of parathyroid hormone that results in hypercalcaemia. The most common cause of primary hyperparathyroidism is solitary adenoma of the parathyroid followed by multiple adenoma, parathyroid hyperplasia and carcinoma, in that order. This paper describes the case of a fifty two year old man who presented with pain and swelling over multiple joints on trivial trauma( right elbow, right knee and left shoulder) against a backdrop of diverse symptoms like anorexia, nausea, weight loss, etc. of insidious onset over the past ten months. Detailed laboratory workup revealed hypercalcaemia (measured on more than one occasion) with concomitant hypophosphatemia, hypercalciuria, raised serum intact parathyroid hormone and elevated skeletal isoenzyme of serum alkaline phospatase. The causes of non parathyroid hypercalcaemia in the differential diagnosis were excluded by the serum 25 hydroxy vitamin D estimation which was found to be in the upper normal range. Finally, the diagnosis was clinched by the serum iPTH assay which is the most sensitive and specific test for parathyroid function. The histological picture was consistent with parathyroid adenoma. Subsequently, surgical resection of the parathyroid achieved normocalcaemia and the patient was discharged with bisphosphonates and calcium supplements.
Keywords: Primary Hyperparathyroidism, Adenoma, Hypercalcaemia
Mousumi Mukhopadhyay, Sharmistha Chattopadhay, Sanghamitra Chakraborty, Swati Bhattacharyya, Soumika Biswas. PRIMARY HYPERPARATHYROIDISM DUE TO BILATERAL PARATHYROID ADENOMA - A CLINICAL CASE REPORT International Journal of Current Research and Review. vol 06 issue 01, January, 95-100
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