Parathyroid adenoma presenting as tetraparesia

Area of Science:

• Endocrinology
• Neurology
• Oncology

Background:

• Parathyroid adenomas (PA) are typically benign tumors.
• Primary hyperparathyroidism (HPT) can manifest with varied symptoms.
• Vitamin D deficiency is a common comorbidity.

Observation:

• A 30-year-old woman presented with tetraparesia and severe muscular atrophy.
• Initial examination revealed significant neurological impairment.
• Delayed diagnosis of PA and Vitamin D deficiency was noted.

Findings:

• Laboratory results showed hypercalcemia, hypophosphatemia, elevated parathyroid hormone (PTH), and severe Vitamin D deficiency.
• Parathyroid scintigraphy confirmed the presence of a parathyroid adenoma.
• Treatment with Vitamin D replacement led to significant clinical and biochemical improvement.

Implications:

• This case underscores the importance of considering primary hyperparathyroidism and Vitamin D deficiency in the differential diagnosis of unexplained neurological symptoms like tetraparesia.
• Early recognition and management are crucial for favorable patient outcomes.
• Physicians should maintain a high index of suspicion for these conditions in patients with atypical presentations.