Primary Hyperparathyroidism: Case report

Abstract

Background: Primary hyperparathyroidism, third most common metabolic disorder worldwide, provokes an increase of serum calcium and parathyroid hormone caused by a hyperactivity of parathyroid glands. In 85% of cases, it is due to a parathyroid adenoma. Predominantly asymptomatic (>80%), its manifestations can be musculoskeletal, neurologic, psychiatric, renal, cardiovascular and gastrointestinal. Clinical case description: 53-year-old female with history of heterozygous familial hypercholesterolemia and arterial hypertension, presents insomnia, nausea, weight loss, myalgia, asthenia, gastroesophageal relux, and irritability. Further exams show hypercalcemia. A right parathyroid gland adenoma is presented through Tc99-sestamibi scintigraphy, along with left benign thyroid nodules. Patient undergoes parathyroidectomy, with posterior satisfactory evolution. Conclusions: Considering primary hyperparathyroidism´s asymptomatic nature predilection and its preference for adenoma presentation, it is necessary to suspect it when hypercalcemia is present. Awareness is necessary not only in the medical ield, but also in the general community through conjoint efforts between the clinical, surgeon, and pathologists. Routine calcium and phosphorus measurements as part of every patient’s scheduled clinical evaluation are strongly suggested in order to enable its detection.