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Pereira FA, Brandão DF, Elias J, et al. Parathyroid adenoma apoplexy as a temporary solution of primary hyperparathyroidism: a case report. J Med Case Rep. 2007;1:139doi: 10.1186/1752-1947-1-139.
Pereira, F. A., Brandão, D. F., Elias, J., & Paula, F. J. (2007). Parathyroid adenoma apoplexy as a temporary solution of primary hyperparathyroidism: a case report. Journal of medical case reports, 1139. https://doi.org/10.1186/1752-1947-1-139
Pereira, Francisco A, et al. "Parathyroid adenoma apoplexy as a temporary solution of primary hyperparathyroidism: a case report." Journal of medical case reports vol. 1 (2007): 139. doi: https://doi.org/10.1186/1752-1947-1-139
Pereira FA, Brandão DF, Elias J, Paula FJ. Parathyroid adenoma apoplexy as a temporary solution of primary hyperparathyroidism: a case report. J Med Case Rep. 2007 Nov 17;1:139. doi: 10.1186/1752-1947-1-139. PMID: 18021421; PMCID: PMC2204027.
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J Med Case Rep. 2007 Nov 17;1:139. doi: 10.1186/1752-1947-1-139.

Parathyroid adenoma apoplexy as a temporary solution of primary hyperparathyroidism: a case report.

Journal of medical case reports

Francisco A Pereira, Daniel F Brandão, Jorge Elias, Francisco Ja Paula

Affiliations

  1. Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. [email protected].

PMID: 18021421 PMCID: PMC2204027 DOI: 10.1186/1752-1947-1-139

Abstract

INTRODUCTION: The natural history of patients with spontaneous parathyroid necrosis is unknown. In this case report we describe the clinical course, laboratory, radiographic, bone densitometry tests, parathyroid ultrasonography and scintigraphy examinations of a patient performed over a period of eight years after she first presented with a sudden episode of spontaneous resolution of primary hyperparathyroidism (PHPT).

CASE PRESENTATION: A 24-year-old woman with a clinical history and laboratory and radiographic tests compatible with PHPT suffered a sudden episode of cervical pain and presented with clinical evidence of hypocalcemia. Biopsy of a cervical nodule revealed necrotic material compatible with ischemia of the parathyroid. The follow-up of the patient presented four distinct phases: the first, which lasted two years, was compatible with a period of bone hunger during which it was necessary to introduce calcitriol and calcium carbonate. During this period, the patient showed bone mass gain. The second phase was characterized by normalization of calcium and parathyroid hormone levels and its end was difficult to define. During the third phase there was a recurrence of hypercalcemia associated with elevated parathyroid hormone (PTH) levels and loss of bone mass. The last phase corresponded to the interval after parathyroidectomy, which was characterized by normalization of serum levels of calcium and PTH, as well as bone mass gain.

CONCLUSION: This case report indicates that spontaneous resolution of PHPT by adenoma necrosis is potentially temporary. Thus, in cases in which a conservative approach is chosen, clinical and laboratory follow-up is indispensable. Bone mass measurement is a useful tool in the follow-up of these cases. However, this option exposes the patient to a potential roller-coaster ride of bone mass gain and loss, whose long term consequences are still unknown.

References

  1. J Am Coll Surg. 2000 Dec;191(6):613-8 - PubMed
  2. Endocr Pract. 2006 Nov-Dec;12(6):630-4 - PubMed
  3. Ann Intern Med. 1991 Apr 1;114(7):593-7 - PubMed
  4. J Clin Ultrasound. 1994 Feb;22(2):134-6 - PubMed
  5. Head Neck. 2006 Jan;28(1):81-8 - PubMed
  6. Medicine (Baltimore). 1998 Nov;77(6):398-402 - PubMed
  7. J Clin Endocrinol Metab. 1996 Apr;81(4):1326-8 - PubMed
  8. QJM. 2000 Jun;93(6):365-7 - PubMed
  9. Eur J Endocrinol. 2002 Jun;146(6):783-8 - PubMed
  10. Am Surg. 2002 Feb;68(2):173-6 - PubMed
  11. Endocr J. 2006 Jun;53(3):311-6 - PubMed
  12. J Bone Miner Res. 2002 Nov;17 Suppl 2:N2-11 - PubMed

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