Parathyroid crisis as first manifestation of primary hyperparathyroidism

Ntaios, George; Savopoulos, C.; Chatzinikolaou, Anastasia; Kaiafa, Georgia; Hatzitolios, Apostolos; Karamitsos, Dimitrios T.

doi:10.1016/j.ejim.2007.02.025

Cited by 13 publications

(7 citation statements)

References 4 publications

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“…Parathyroid crisis is an uncommon life-threatening complication of primary hyperparathyroidism and its prognosis is poor; therefore, it requires aggressive medical therapy and early surgical treatment. [ 1 ] In the majority of cases, it is a complication of already diagnosed primary hyperparathyroidism. However, in our patient, parathyroid crisis was the first manifestation of primary hyperparathyroidism since the calcium was normal five weeks before this admission.…”

Section: Discussionmentioning

confidence: 99%

“…Since parathyroid crisis is life threatening and its prognosis is poor, it requires aggressive medical therapy and early surgical treatment. [ 1 ] The combination of imaging techniques has incremental value in localizing ectopic parathyroid adenomas over either technique alone.…”

Section: Discussionmentioning

confidence: 99%

“…Parathyroid crisis requires aggressive medical therapy and early surgical treatment. [ 1 ] Ectopic parathyroid glands continue to be a diagnostic and operative challenge in patients with hyperparathyroidism. Difficulties in locating the ectopic parathyroid adenoma may delay the diagnosis and subsequent surgery.…”

Section: Introductionmentioning

confidence: 99%

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A case report of mediastinal ectopic parathyroid adenoma presented as parathyroid crisis localized by SPECT/CT

Zhou

Chen

2016

Medicine

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Introduction:Parathyroid crisis due to ectopic parathyroid adenomas can pose diagnostic and management challenges, since it is quite rare in clinical practice.Clinical Findings/Patient Concerns:A 67-year-old Chinese male presented as a parathyroid crisis due to an ectopic mediastinal parathyroid adenoma with his serum calcium and PTH markedly increased in short time. An ultrasonography and computed tomography (CT) scan of the neck did not reveal any parathyroid adenoma. Thoracic CT detected a contrast-enhanced mass in the mediastinum. Although the ectopic location is difficult to appreciate on anterior planar technetium-99m-sestamibi scintigraphy views but has been accurately localized with single photon-emission computed tomography/computed tomography. After fluid resuscitation, loop diuretic, and calcitonin treatment, a thoracoscope surgery was performed. The histopathology of the mediastinal nodule was consistent with a parathyroid adenoma. Hypocalcemia due to hungry bone syndrome occurred after surgery and was resolved quickly with large-dose calcium and calcitriol supplementation. He is asymptomatic and has normal serum calcium and PTH levels on regular follow-up.Diagnoses:The ultrasonography, CT, sestamibi, and single photon-emission computed tomography/computed tomography provide limited sensitivity in the detecting ectopic parathyroid adenomas alone. The combination of these techniques has incremental value in localizing ectopic parathyroid adenomas over either technique alone.Conclusion:Any parathyroid crisis without parathyroid adenoma in the neck should alert physicians to search for ectopic locations through combination of imaging techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A case report of mediastinal ectopic parathyroid adenoma presented as parathyroid crisis localized by SPECT/CT

Zhou

Chen

2016

Medicine

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“…Primary hyperparathyroidism is a rare disease, where the majority of patients now present asymptomatically after biochemical testing which shows a mildly raised serum CCa 2+ and marginally elevated PTH level [3]. However, our case highlights two important aspects of parathyroid disease that the authors would like to explore further.…”

Section: Discussionmentioning

confidence: 90%

A Parathyroid Adenoma: Benign Disease Presenting with Hyperparathyroid Crisis

Tahim

Saunders

Sinha

2010

Case Reports in Medicine

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Hyperparathyroid crisis is a rare manifestation of parathyroid disease. We present the case of a 53-year-old gentleman with a review of the current literature. He presented in acute renal failure with epigastric pain and vomiting. His serum-corrected calcium (CCa2+) was raised at 5.2 mmol/L, in addition to a massively raised parathyroid hormone (PTH) level (3957 ng/L). Ultrasound studies of the neck revealed a 2 cm well-defined mass inferoposterior to right thyroid lobe. CT scans of the neck showed a normal mediastinum and confirmed no associated lymphadenopathy. Having undergone medical resuscitation for 9 days, a neck exploration revealed a cystic mass, which was excised. Histological investigations revealed a 9.25 g, cystic parathyroid adenoma with no features of malignancy. His PTH and CCa2+ returned to normal postoperatively. This suspicious presentation of benign disease, including a marked elevation in PTH, highlights the challenges facing the endocrine surgeon in dealing with parathyroid disease.

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“…[2] However, our case highlights two important aspects of parathyroid disease that the authors would like to highlight. First, the difficulty was faced preoperatively in the management of a patient presenting with hyperparathyroid crisis and managing the same patient postoperatively for hypocalcemia due to HBS.…”

Section: Discussionmentioning

confidence: 93%

Protean presentations of parathyroid adenoma in childhood

Dey

Beawarwala

Gupta

2017

J Indian Assoc Pediatr Surg

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Parathyroid adenoma is a rare disease which is known to present with protean manifestations, leading to misdiagnosis in the initial stage of the disease. It is known to pose a diagnostic dilemma to the clinician, in which a high index of suspicion alone often leads to a proper diagnosis and timely management. We encountered two such cases who presented to us with varied presentation, in which nuclear scintigraphy along with intraoperative parathyroid hormone assay played a major role in diagnosis and management.

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Parathyroid crisis as first manifestation of primary hyperparathyroidism

Cited by 13 publications

References 4 publications

A case report of mediastinal ectopic parathyroid adenoma presented as parathyroid crisis localized by SPECT/CT

A case report of mediastinal ectopic parathyroid adenoma presented as parathyroid crisis localized by SPECT/CT

A Parathyroid Adenoma: Benign Disease Presenting with Hyperparathyroid Crisis

Protean presentations of parathyroid adenoma in childhood

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