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Primary hyperparathyroidism: a case with severe skeletal manifestations
Annals of the Academy of Medicine, Singapore
|November 1, 1995
Summary
Primary hyperparathyroidism can present with severe bone pain and fractures. Surgical removal of parathyroid adenoma improved patient outcomes, despite initial hypocalcaemia.
Area of Science:
- Endocrinology
- Skeletal Diseases
- Surgical Case Reports
Background:
- Primary hyperparathyroidism (PHPT) is frequently asymptomatic, diagnosed incidentally via hypercalcaemia.
- Uncommon, severe presentations of PHPT, such as significant bone pain and fractures, warrant detailed reporting.
Observation:
- A middle-aged male presented with severe bone pain and bilateral femoral neck fractures.
- Diagnosis revealed a solitary parathyroid adenoma as the cause of hypercalcaemia.
- Surgical resection of the parathyroid adenoma was performed.
Findings:
- Post-surgery, the patient experienced severe symptomatic hypocalcaemia requiring intensive replacement therapy.
- Treatment included calcium, magnesium, and active vitamin D supplementation.
- At 3-month follow-up, the patient showed clinical well-being and improved biochemical markers.
Implications:
- This case highlights the importance of considering PHPT in patients with unexplained bone pain and fractures.
- Successful surgical management of parathyroid adenoma can lead to significant recovery.
- Aggressive postoperative management of hypocalcaemia is crucial for patient recovery.