PRIMARY HYPERPARATHYROIDISM: CASE REPORT OF ADVANCED DISEASE

Dr. Mahesh Brungi*, Dr. Prathap B., Dr. Abdul Gafoor P. M., Dr. Nazneen Abdul Kader, Dr. Ajith T. Abraham

ABSTRACT

Primary hyperparathyroidism is a condition characterized by hyper function of one or more parathyroid glands leading to uncontrolled secretion of parathyroid hormone. The most common cause of primary hyperparathyroidism is parathyroid adenoma, followed by hyperplasia and carcinoma in 1 to 2% of cases. Patients most commonly presents with symptoms of hypercalcemia which occurs due to increased resorption of calcium from bones, increased absorption of calcium in bowels and decreased urinary elimination of calcium. Clinically patient presents with multiple bone pain, loss of appetite, nausea, vomiting, loss of weight, constipation, depression and symptoms of nephrolithiasis. Diagnosis is mainly based on the clinical presentation and serum levels of calcium, phosphorus, alkaline phosphatase, albumin and parathormone levels, ultrasonography of neck with FNAC studies and sestamibi scan for parathyroid gland. Here we are reporting a case of a middle aged woman with primary hyperparathyroidism who presented to us with advanced disease. After thorough clinical, laboratory and radiological evaluation, primary hyperparathyroidism due to adenoma in the left parathyroid lobe was diagnosed for which she underwent focused parathyroidectomy. Intra op frozen section confirmed the adenoma. After symptomatic and supportive therapy, she was completely normal and resumed all her daily activities.

Keywords: Primary Hyperparathyroidism, Parathyroid adenoma, Brown tumour, Sestamibi scan.