TITLE:
Primary Hyperparathyroidism Revealed by Impaired Renal Function with Persistent Elevation of Parathormon (PTH) and Normal Calcemia after Surgical Removal of the Parathyroid Adenoma
AUTHORS:
Yao Assita, Lecadou Jocelyne, Maman Salahoudine, N’guessan Anselme, Danho Jocelyne, Kouassi Frank, Hué Adélaïde, Koffi Dago Pierre, Abodo Jacko
KEYWORDS:
Primary Hyperparathyroidism, Postoperative Follow-Up, Normocalcemic Hyperparathormonemia
JOURNAL NAME:
Open Journal of Endocrine and Metabolic Diseases,
Vol.13 No.2,
February
15,
2023
ABSTRACT: Introduction: The curative management of primary hyperparathyroidism is based on
surgery. We report the case of a patient presenting with elevated parathormone
despite surgical removal of the parathyroid adenoma. Observation: A 48-year-old
patient presented for more than 6 months with significant weight loss, polyuria with
polydipsia and impaired renal function. The assessment carried out revealed
hypercalcaemia at 155 mg/L with hypophastetaemia at 24 mg/L and an elevation of
the parathyroid hormone at 218.9 pg/ml. Cervical ultrasound showed a mass at
the expense of the lower left parathyroid gland. These results made it possible
to conclude primary hyperparathyroidism by parathyroid adenoma which was
supported surgically. The postoperative biological assessment revealed a
normocalcemia at 85 mg/L associated with an increase in parathormone (PTH)
at 271.9 pg/ml. In front of the normalization of calcemia in the subsequent
controls and the amendment of all the signs, monitoring was carried out. 9
months after surgery, spontaneous normalization of PTH was observed at 38.4
pg/ml with normal serum calcium at 90 mg/l. Discussion: Primary
hyperparathyroidism can be revealed by other manifestations. Post-operative
follow-up is generally simple with normalization of PTH and serum calcium.
However, there may persist an elevation of PTH with normal self-limiting
calcemia.