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A Case of Primary Hyperparathyroidism Found by Parathyroid Crisis

The bulletin of the Yamaguchi Medical School Volume 51 Issue 1-2 Page 17-21
published_at 2004-06
A020051000103.pdf
[fulltext] 145 KB
Title
A Case of Primary Hyperparathyroidism Found by Parathyroid Crisis
Creators Sakuragi Shizu
Creators Taguchi Akihiko
Creators Miyazaki Mutsuko
Creators Mitani Noriyuki
Creators Matsuda Kazuyuki
Creators Fukuda Naofumi
Creators Inoue Yasushi
Source Identifiers
Creator Keywords
hyperparathyroidism parathyroid crisis intact-PTH hypercalcemia
A 75-year-old women, who had been well until 2 weeks ago, consulted a phychiatrist because of stupor and appetite loss. A high serum calcium level (16.4mg/dl) was found and she was referred to our department. Calcium level rapidly increased to 25.2 mg/dl within a week regardless of a large amount of saline infusion with simultaneous administation of diuretics, calcitonin and prednisolone. Serum calsium level decreased gradually after six times of hemodialyses and infusion of bisphosphonate, pamidronate disodium. The level of intact PTH turned out to be extremely high (520pg/ml) and PTH-related protain was in the normal range. Parathyroid crisis due to primary hyparathyroidism was diagnosed. Procedures aim to localize the affected parathyroid glands including ultrasonography, computed tomography, magnetic resonance imaging and subtraction scintigraphy failed. Technetium 99m sestamibi scan after sedation with diazepan showed an abnormal image just below the right lobe of the thyroid. During the neck operation, an adenoma (3 x 1 cm) was detected and resected completely. No other affected glands were found. The levels of serum calcium due to persistent hypercalcemia remained six months later after the operation.
Subjects
医学 ( Other)
Languages eng
Resource Type departmental bulletin paper
Publishers Yamaguchi University Graduate School of Medicine
Date Issued 2004-06
File Version Version of Record
Access Rights open access
Relations
[ISSN]0513-1812
[NCID]AA00594272
Schools 医学部