An instructive case suggesting cyclical primary hyperparathyroidism.

نویسندگان

  • Noriko Makita
  • Taroh Iiri
  • Junichiro Sato
  • Seiji Fukumoto
  • Tomoki Okazaki
  • Kiyomi Yamazaki
  • Takao Obara
  • Toshiro Fujita
چکیده

We report an instructive case of primary hyperparathyroidism in which cyclical secretion of PTH may have caused repeated hypercalcemic crises followed by temporary remission with a spontaneous drop in PTH. A 64-year-old man was admitted to our hospital twice with severe hypercalcemic crisis (corrected calcium (cCa) 15.0 mg/dl and 16.7 mg/dl) accompanied by an increase in intact PTH (220 pg/ml and 470 pg/ml). During both events, the serum PTH values spontaneously dropped followed by remission of the hypercalcemia. The tumor, detected at the left-upper side, showed neither vascularity on ultrasound examination nor washout delay on MIBI scintigraphy, suggesting that two parathyroid adenoma infarctions had occurred. Cervical exploration was undertaken. The histopathological examinations confirmed that the tumor was parathyroid adenoma. Contrary to our expectation, however, it did not reveal necrotic tissue that would indicate recent infarction. The findings in this case may be explained by cyclical secretion of PTH from a parathyroid adenoma. Although cyclical Cushing's syndrome is well known, to our knowledge this is the first documented case suggesting cyclical primary hyperparathyroidism.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Scintigraphic evaluation of multifocal osteolytic lesions in a patient with primary hyperparathyroidism: A case report

Osteitis fibrosa cystica is the classic patognomonic form of skeletal disease in hyperparathyroidism that characterizes with decreased cortical bone thickness compared to increased cancellous bone. We present a case of 52-year old female patient with osteolysis of the left calf on radiographic images. The bone scan detected multiple focal pathological accumulations in the skull, left tibia, bot...

متن کامل

Myelofibrosis due to Secondary Hyperparathyroidism in a Case of Celiac Disease

Myelofibrosis is reported in patents with primary hyperparathyroidism. It is also was reported in patents with sec- ondary hyperparathyroidism due to end-stage renal disease or Vitamin D dependent rickets .We present a case of celiac disease and osteomalacia which leads to secondary hyperparathyroidism and myelofibrosis.

متن کامل

Brown tumor of the mandible: Magnetic susceptibility demonstrated by MRI

We present a case of a 75-year-old woman with right mandible cystic lesion and primary hyperparathyroidism. The MRI demonstrated marked loss of signal intensity on T2 gradient-echo images, suggesting intralesional hemossiderin. After an open biopsy, histology was consistent with "brown tumor." The finding of susceptibility on T2 gradient-echo images in a mandible lesion adds considerable specif...

متن کامل

Early Onset Primary Hyperparathyroidism Associated with a Novel Germline Mutation in CDKN1B

Individuals presenting with primary hyperparathyroidism (PHPT) at a young age commonly have an underlying germline gene mutation in one of the following genes: MEN1, CASR, or CDC73. A small number of families with primary hyperparathyroidism have been identified with germline mutations in CDKN1B and those patients with primary hyperparathyroidism have almost exclusively been women who present i...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Endocrine journal

دوره 53 3  شماره 

صفحات  -

تاریخ انتشار 2006