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Constipation as an Atypical Presentation of Hyperparathyroidism: A Case Report
Ioannis Xefteris1, Argyrios Periferakis2,3,4, Loredana Goran1
1Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
The American Journal of Case Reports
|September 17, 2025
Summary
Primary hyperparathyroidism can present with subtle gastrointestinal symptoms. Early diagnosis through calcium and parathormone level checks is crucial for managing this endocrine disorder.
Area of Science:
- Endocrinology
- Gastroenterology
Background:
- Hyperparathyroidism is an endocrine disorder with increasing prevalence.
- It can cause severe, life-threatening hypercalcemia.
- Prompt diagnosis and treatment are essential, even with atypical symptoms.
Purpose of the Study:
- To report a case of hyperparathyroidism presenting solely with gastrointestinal symptoms.
- To highlight the importance of considering hyperparathyroidism in patients with unexplained GI issues.
Main Methods:
- Case report of a 77-year-old woman with severe constipation and weight loss.
- Diagnostic workup included computed tomography, laboratory tests (calcium, parathormone, ferritin, creatinine), and anemia assessment.
- Imaging revealed vascular calcifications and liver microcalcifications.
Main Results:
- Patient presented with severe hypercalcemia (serum calcium >15 mg/dL) and elevated parathormone levels (>1000 pg/mL).
- Primary hyperparathyroidism was diagnosed, attributed to a parathyroid adenoma.
- Gastrointestinal symptoms were the only presenting complaints.
Conclusions:
- Clinical awareness can lead to the diagnosis of hyperparathyroidism in patients with unexplained gastrointestinal symptoms.
- Prompt laboratory testing of calcium and parathormone levels is key for early detection.
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