Special case of primary hyperparathyroidism late diagnosis
https://doi.org/10.14341/serg10265
Abstract
Primary hyperparathyroidism is a socially significant problem due to the fact that the analysis of blood calcium in Russia is not a routine biochemical test, and diagnosis is carried out at the stage of irreversible complications. So, a patient addressed to our clinic which had a clinical picture of hyperparathyroidism complications over time. In the hospital diagnostic studies were carried out, including, first of all, a determination of calcium in blood, followed by more comprehensive survey, on the basis of which hyperparathyroidism has been confirmed. An adenoma of the left lower parathyroid gland was found by the method of topical diagnosis (ultrasound of the parathyroid glands and scintigraphy with Tc-99m-technetril). After the surgical treatment a level of calcium and a level of PTH have declined significantly. The combination of calcium and vitamin D supplementation was prescribed about intensive saturation therapy was needed with intense post-operative hyperparathyroidism. Given the existence of osteo-visceral complications by hyperparathyroidism, at the moment the patient needs a long rehabilitation course. This case shows that in order to avoid late diagnostics, it seems necessary to determine the level of calcium for routine. Therefore, it is possible to prevent the development of complications of the disease and the disability of patients.
About the Authors
Viktoriya V. TroshinaRussian Federation
resident
Nonna V. Latkina
Russian Federation
MD, PhD
Elizaveta O. Mamedova
Russian Federation
MD, PhD
Zhanna E. Belaya
Russian Federation
MD, PhD, Professor
Nikolay S. Kuznetzov
Russian Federation
MD, PhD, Professor
References
1. Дедов И.И., Мельниченко Г.А., Мокрышева Н.Г., и др. Первичный гиперпаратиреоз: клиника, диагностика, дифференциальная диагностика, методы лечения. Клинические рекомендации. // Проблемы эндокринологии. – 2016. – T. 62. – №6. – С. 40-77. [Dedov II, Melnichenko GA, Mokrysheva NG, et al. Primary hyperparathyroidism: the clinical picture, diagnostics, differential diagnostics, and methods of treatment. Problems of Endocrinology. 2016;62(6):40-77. (In Russ.)] doi: https://doi.org/10.14341/probl201662640-77.
2. Кеттайл В.М., Арки Р.А. Патофизиология эндокринной системы. / Под общ. ред. Наточина Ю.В.; пер. с англ. под ред. Смирнова Н.А. – М.: БИНОМ; 2010. – С. 145-155. [Kettyle WM, Arky RA. Endocrine pathophysiology. Ed by Natochin Yu.V.; translation from English ed by Smirnov N.A. Moscow: Binom; 2010. p. 145-155. (In Russ.)]
3. Мамедова Е.О., Мокрышева Н.Г., Рожинская Л.Я. Особенности первичного гиперпаратиреоза у пациентов молодого возраста. // Проблемы эндокринологии. – 2018. – T. 64. – №3. – С. 163-169. [Mamedova EO, Mokrysheva NG, Rozhinskaya LYa. Characteristics of primary hyperparathyroidism in young patients. Problems of Endocrinology. 2018;64(3):163-169. (In Russ.)] doi: https://doi.org/10.14341/probl9399.
4. Мокрышева Н.Г. Первичный гиперпаратиреоз (эпидемиология, клиника, современные принципы диагностики и лечения): Автореферат дисс. … докт. мед. наук. – М.; 2011. – 47 c. [Mokrysheva NG. Pervichnyi giperparatireoz (epidemiologiya, klinika, sovremennye printsipy diagnostiki i lecheniya) [dissertation abstract]. Moscow; 2011. 47 p. (In Russ.)] Доступно по: http://medical-diss.com/medicina/pervichnyy-giperparatireoz. Ссылка активна на 12.08.2019.
5. Первичный гиперпаратиреоз: Клиника, диагностика, дифференциальная диагностика, методы лечения. Проект федеральных клинических рекомендаций. / Под ред. Дедова И.И., Мельниченко Г.А. – М.; 2016. – 90 c. [Pervichnyi giperparatireoz: Klinika, diagnostika, differentsial'naya diagnostika, metody lecheniya. Proekt federal'nykh klinicheskikh rekomendatsii. Ed by Dedov I.I., Mel'nichenko G.A. Moscow; 2016. 90 p. (In Russ.)]
6. Сапожникова И.Е. Особенности клинического течения первичного гиперпаратиреоза. // Терапевтический архив. – 2018. – T. 90. – №10. – С. 51-54. [Sapozhnikova IE. Primary hyperparathyroidism clinical features on endocrinology in-patients clinic. Ter Arkh. 2018;90(10):51-54. (In Russ.)] doi: https://doi.org/10.26442/terarkh2018901051-54.
7. Assadipour Y, Zhou H, Kuo E, et al. End-organ effects of primary hyperparathyroidism: a population-based study. Surgery. 2019;165(1):99-104. doi: https://doi.org/10.1016/j.surg.2018.04.088.
8. Giusti F, Cavalli L, Cavalli T, Brandi ML. Hereditary hyperparathyroidism syndromes. J Clin Densitom. 2013;16(1):69-74. doi: https://doi.org/10.1016/j.jocd.2012.11.003.
9. Bilezikian JP, Silva BC, Cusano NE. Primary hyperparathyroidism – hypercalcemic and normocalcemic variants. Curr Opin Endocr Metab Res. 2018;3:42-50. doi: https://doi.org/10.1016/j.coemr.2018.03.003.
10. Khan A, Hanley D, Rizzoli R, et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporos Int. 2016;28(1):1-19. doi: https://doi.org/10.1007/s00198-016-3716-2.
11. Langer P, Wild A, Hall A, et al. Prevalence of multiple endocrine neoplasia type 1 in young patients with apparently sporadic primary hyperparathyroidism or pancreaticoduodenal endocrine tumours. Br J Surg. 2003;90(12):1599-1603. doi: https://doi.org/10.1002/bjs.4355.
Supplementary files
|
1. Fig. 1. Kidney stones. | |
Subject | ||
Type | Other | |
View
(295KB)
|
Indexing metadata ▾ |
|
2. Fig. 2. Brown tumors. | |
Subject | ||
Type | Other | |
View
(157KB)
|
Indexing metadata ▾ |
|
3. Fig. 3. The left and right humerus. | |
Subject | ||
Type | Other | |
View
(274KB)
|
Indexing metadata ▾ |
Review
For citations:
Troshina V.V., Latkina N.V., Mamedova E.O., Belaya Zh.E., Kuznetzov N.S. Special case of primary hyperparathyroidism late diagnosis. Endocrine Surgery. 2019;13(2):95-100. (In Russ.) https://doi.org/10.14341/serg10265

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).