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[Bone pain, polydipsia, polyuria]

Y D Ko1, S Seewald, H Stiebler

  • 1Medizinische Universitäts-Poliklinik, Bonn.

Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|February 15, 1994
PubMed
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A 20-year-old man presented with bone pain, weakness, and weight loss. Investigations revealed hypercalcemia and elevated parathyroid hormone, leading to a diagnosis of primary hyperparathyroidism with fibrosing osteitis.

Area of Science:

  • Endocrinology
  • Oncology
  • Orthopedics

Background:

  • This case highlights a rare presentation of primary hyperparathyroidism.
  • Fibrosing osteitis, also known as von Recklinghausen's disease of bone, is a rare skeletal manifestation of hyperparathyroidism.

Observation:

  • A 20-year-old male experienced progressive multifocal bone pain, leg weakness, sensory loss, weight loss, polydipsia, and pollakiuria.
  • Clinical examination revealed hard tumors in the mandible and tibia, gait abnormalities, reduced muscle force, sensory deficits, and hypertension.
  • Radiographic imaging showed multiple cystic bone lesions throughout the skeleton.

Findings:

  • Laboratory results indicated significant hypercalcemia and markedly elevated parathyroid hormone levels.
  • Sonography revealed enlarged parathyroid glands, confirming primary hyperparathyroidism.

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  • The constellation of symptoms, imaging, and biochemical findings led to the diagnosis of primary hyperparathyroidism with fibrosing osteitis.

    • Implications:

    • This case underscores the importance of considering rare endocrine disorders in young patients with complex skeletal and metabolic symptoms.
    • Early diagnosis and management of primary hyperparathyroidism are crucial to prevent severe skeletal complications and systemic effects.
    • Fibrosing osteitis, though rare, necessitates a thorough evaluation for underlying parathyroid pathology.