Renal Papillary Necrosis Associated With Normocalcemic Primary Hyperparathyroidism

Area of Science:

• Nephrology
• Endocrinology
• Oncology

Background:

• Primary hyperparathyroidism (PHPT) is a common endocrine disorder.
• Renal papillary necrosis (RPN) is a known complication of various conditions but has not been previously reported in PHPT.
• Hypercalciuria is a frequent finding in PHPT.

Observation:

• A 50-year-old woman with a history of parathyroidectomy for PHPT and a bronchial carcinoid tumor presented with bilateral RPN.
• Imaging studies, including ultrasound and CT scan, confirmed the diagnosis of RPN.
• Despite previous hypercalcemia, her current presentation showed normocalcemia with elevated parathyroid hormone (PTH) and hypercalciuria.

Findings:

• This case suggests a potential association between RPN and normocalcemic PHPT with hypercalciuria.
• The patient had no other risk factors for RPN such as diabetes, hypertension, or analgesic use.
• The findings challenge the typical understanding of RPN etiology.

Implications:

• RPN should be considered in patients with PHPT, even in the normocalcemic state.
• Further research with larger cohorts is necessary to confirm this association.
• Understanding this link may improve diagnostic and management strategies for patients with PHPT and renal complications.