Persistent Primary Hyperparathyroidism, Severe Vitamin D Deficiency, and Multiple Pathological Fractures
Persistent primary hyperparathyroidism (PHPT) refers to the sustained hypercalcemia state detected within the first six months following parathyroidectomy. When it coexists with severe vitamin D deficiency, the effects on bone can be devastating. We report the case of a 56-year-old woman who was sen...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2016-01-01
|
| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2016/3016201 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841524847343042560 |
|---|---|
| author | Victoria Mendoza-Zubieta Mauricio Carvallo-Venegas Jorge Alberto Vargas-Castilla Nicolás Ducoing-Sisto Alfredo Alejandro Páramo-Lovera Lourdes Josefina Balcázar-Hernández Julián Malcolm Mac Gregor-Gooch |
| author_facet | Victoria Mendoza-Zubieta Mauricio Carvallo-Venegas Jorge Alberto Vargas-Castilla Nicolás Ducoing-Sisto Alfredo Alejandro Páramo-Lovera Lourdes Josefina Balcázar-Hernández Julián Malcolm Mac Gregor-Gooch |
| author_sort | Victoria Mendoza-Zubieta |
| collection | DOAJ |
| description | Persistent primary hyperparathyroidism (PHPT) refers to the sustained hypercalcemia state detected within the first six months following parathyroidectomy. When it coexists with severe vitamin D deficiency, the effects on bone can be devastating. We report the case of a 56-year-old woman who was sent to this center because of persistent hyperparathyroidism. Her disease had over 3 years of evolution with nephrolithiasis and hip fracture. Parathyroidectomy was performed in her local unit; however, she continued with hypercalcemia, bone pain, and pathological fractures. On admission, the patient was bedridden with multiple deformations by fractures in thoracic and pelvic members. Blood pressure was 100/80, heart rate was 86 per minute, and body mass index was 19 kg/m2. Calcium was 14 mg/dL, parathormone 1648 pg/mL, phosphorus 2.3 mg/dL, creatinine 2.4 mg/dL, urea 59 mg/dL, alkaline phosphatase 1580 U/L, and vitamin D 4 ng/mL. She received parenteral treatment of hypercalcemia and replenishment of vitamin D. The second surgical exploration was radioguided by gamma probe. A retroesophageal adenoma of 4 cm was resected. Conclusion. Persistent hyperparathyroidism with severe vitamin D deficiency can cause catastrophic skeletal bone softening and fractures. |
| format | Article |
| id | doaj-art-3ffc2430b84d4a0bae4b7d905307f04f |
| institution | Kabale University |
| issn | 2090-6501 2090-651X |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Endocrinology |
| spelling | doaj-art-3ffc2430b84d4a0bae4b7d905307f04f2025-02-03T05:47:16ZengWileyCase Reports in Endocrinology2090-65012090-651X2016-01-01201610.1155/2016/30162013016201Persistent Primary Hyperparathyroidism, Severe Vitamin D Deficiency, and Multiple Pathological FracturesVictoria Mendoza-Zubieta0Mauricio Carvallo-Venegas1Jorge Alberto Vargas-Castilla2Nicolás Ducoing-Sisto3Alfredo Alejandro Páramo-Lovera4Lourdes Josefina Balcázar-Hernández5Julián Malcolm Mac Gregor-Gooch6Endocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, 06720 Mexico City, DF, MexicoFaculty of Medicine, Universidad Nacional Autónoma de México (UNAM), 04510 Mexico City, DF, MexicoFaculty of Medicine, Universidad Nacional Autónoma de México (UNAM), 04510 Mexico City, DF, MexicoFaculty of Medicine, Universidad Nacional Autónoma de México (UNAM), 04510 Mexico City, DF, MexicoFaculty of Medicine, Universidad Nacional Autónoma de México (UNAM), 04510 Mexico City, DF, MexicoEndocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, 06720 Mexico City, DF, MexicoDivision of Medicine, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, 06720 Mexico City, DF, MexicoPersistent primary hyperparathyroidism (PHPT) refers to the sustained hypercalcemia state detected within the first six months following parathyroidectomy. When it coexists with severe vitamin D deficiency, the effects on bone can be devastating. We report the case of a 56-year-old woman who was sent to this center because of persistent hyperparathyroidism. Her disease had over 3 years of evolution with nephrolithiasis and hip fracture. Parathyroidectomy was performed in her local unit; however, she continued with hypercalcemia, bone pain, and pathological fractures. On admission, the patient was bedridden with multiple deformations by fractures in thoracic and pelvic members. Blood pressure was 100/80, heart rate was 86 per minute, and body mass index was 19 kg/m2. Calcium was 14 mg/dL, parathormone 1648 pg/mL, phosphorus 2.3 mg/dL, creatinine 2.4 mg/dL, urea 59 mg/dL, alkaline phosphatase 1580 U/L, and vitamin D 4 ng/mL. She received parenteral treatment of hypercalcemia and replenishment of vitamin D. The second surgical exploration was radioguided by gamma probe. A retroesophageal adenoma of 4 cm was resected. Conclusion. Persistent hyperparathyroidism with severe vitamin D deficiency can cause catastrophic skeletal bone softening and fractures.http://dx.doi.org/10.1155/2016/3016201 |
| spellingShingle | Victoria Mendoza-Zubieta Mauricio Carvallo-Venegas Jorge Alberto Vargas-Castilla Nicolás Ducoing-Sisto Alfredo Alejandro Páramo-Lovera Lourdes Josefina Balcázar-Hernández Julián Malcolm Mac Gregor-Gooch Persistent Primary Hyperparathyroidism, Severe Vitamin D Deficiency, and Multiple Pathological Fractures Case Reports in Endocrinology |
| title | Persistent Primary Hyperparathyroidism, Severe Vitamin D Deficiency, and Multiple Pathological Fractures |
| title_full | Persistent Primary Hyperparathyroidism, Severe Vitamin D Deficiency, and Multiple Pathological Fractures |
| title_fullStr | Persistent Primary Hyperparathyroidism, Severe Vitamin D Deficiency, and Multiple Pathological Fractures |
| title_full_unstemmed | Persistent Primary Hyperparathyroidism, Severe Vitamin D Deficiency, and Multiple Pathological Fractures |
| title_short | Persistent Primary Hyperparathyroidism, Severe Vitamin D Deficiency, and Multiple Pathological Fractures |
| title_sort | persistent primary hyperparathyroidism severe vitamin d deficiency and multiple pathological fractures |
| url | http://dx.doi.org/10.1155/2016/3016201 |
| work_keys_str_mv | AT victoriamendozazubieta persistentprimaryhyperparathyroidismseverevitaminddeficiencyandmultiplepathologicalfractures AT mauriciocarvallovenegas persistentprimaryhyperparathyroidismseverevitaminddeficiencyandmultiplepathologicalfractures AT jorgealbertovargascastilla persistentprimaryhyperparathyroidismseverevitaminddeficiencyandmultiplepathologicalfractures AT nicolasducoingsisto persistentprimaryhyperparathyroidismseverevitaminddeficiencyandmultiplepathologicalfractures AT alfredoalejandroparamolovera persistentprimaryhyperparathyroidismseverevitaminddeficiencyandmultiplepathologicalfractures AT lourdesjosefinabalcazarhernandez persistentprimaryhyperparathyroidismseverevitaminddeficiencyandmultiplepathologicalfractures AT julianmalcolmmacgregorgooch persistentprimaryhyperparathyroidismseverevitaminddeficiencyandmultiplepathologicalfractures |