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Masked primary (or tertiary) hyperparathyroidism.

C E Dent, P E Jones, D P Mullan

    Lancet (London, England)
    |May 24, 1975
    PubMed
    Summary
    This summary is machine-generated.

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    Two patients initially diagnosed with osteomalacia developed hypercalcemia after treatment. Surgery revealed parathyroid tumors, suggesting masked tertiary hyperparathyroidism. This highlights challenges in diagnosing hyperparathyroidism.

    Area of Science:

    • Endocrinology
    • Nephrology
    • Gastroenterology

    Background:

    • Osteomalacia can be associated with gluten-sensitive enteropathy and anticonvulsant therapy.
    • Hypercalcemia is a key indicator of hyperparathyroidism, but its interpretation can be complex.
    • Tertiary hyperparathyroidism may present with masked or normocalcemic states.

    Purpose of the Study:

    • To describe two cases of osteomalacia that developed hypercalcemia post-treatment.
    • To investigate the underlying cause of hypercalcemia in these patients.
    • To explore the concept of masked tertiary hyperparathyroidism.

    Main Methods:

    • Clinical case presentation of two patients.
    • Laboratory investigations including plasma calcium and 25-hydroxyvitamin D levels.

    Related Experiment Videos

  • Surgical exploration and histopathological examination for parathyroid tumors.

    • Main Results:

    • Both patients initially presented with osteomalacia symptoms.
    • Treatment for osteomalacia led to the development of hypercalcemia.
    • Parathyroid tumors were identified in both patients, indicating tertiary hyperparathyroidism.

    Conclusions:

    • The study suggests that tertiary hyperparathyroidism can be masked by underlying conditions like osteomalacia.
    • Normocalcemic hyperparathyroidism may be underdiagnosed due to masking effects.
    • Accurate interpretation of plasma calcium requires consideration of 25-hydroxyvitamin D levels.