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Published on: March 14, 2017
A case of primary hyperparathyroidism with severe bone and renal changes
Rika Jimbo-Saito1, Yoshifumi Ubara, Hiraku Kadoguchi
1Nephrology Center, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa 213-0015, Japan.
Journal of Bone and Mineral Metabolism
|March 4, 2009
Summary
Early detection of primary hyperparathyroidism (HPT) is crucial. Prompt treatment can prevent severe bone disease, especially in patients with kidney failure, as renal dysfunction accelerates bone changes.
Area of Science:
- Endocrinology
- Nephrology
- Bone Biology
Background:
- Primary hyperparathyroidism (HPT) can lead to severe skeletal complications.
- End-stage renal disease (ESRD) significantly impacts bone metabolism.
Observation:
- A 79-year-old woman with ESRD presented with severe bone pain, fractures, and muscle weakness.
- Biochemical markers indicated severe HPT (PTH 2,710 pg/ml) and renal failure (Cr 4.7 mg/dl).
- Bone biopsy revealed osteitis fibrosa with predominant bone resorption.
Findings:
- Total parathyroidectomy (PTX) led to complete resolution of bone pain.
- Histomorphometry confirmed excessive osteoclast activity over osteoblast activity.
- ESRD exacerbated the bone manifestations of HPT.
Implications:
- Early diagnosis and treatment of primary HPT are essential to prevent debilitating bone disease.
- Renal dysfunction accelerates bone resorption in HPT patients.
- Timely intervention can mitigate skeletal damage and improve patient outcomes.
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