Symptomatic primary hyperparathyroidism. Clinical case

T.Yu. Demidova, Yu.S. Kishkovich

Pirogov Russian National Research Medical University, Moscow

Symptomatic primary hyperparathyroidism is a severe disease, sometimes difficult to diagnose, since the study of total and ionized calcium level is not included in the screening standards nowadays. Commonly, the diagnosis is established already in the presence of bone and visceral lesions, such as calcification of heart muscle and valves, nephrolithiasis, cholelithiasis, gastric and duodenal ulcers, visual acuity reduction, as well as osteopenia and osteoporosis pathogenesis. Timely diagnosis, instrumental confirmation, and additional examination of systems and organs will prevent possible severe complications, including heart failure, chronic renal failure, and low-energy fractures. Diagnosis of the symptomatic primary hyperparathyroidism using laboratory data with elevated levels of calcium and parathyroid hormone is not difficult. However, it is not always possible to verify the localization of hormo ne-producing parathyroid adenoma. The article presents the case of the patient with primary hyperparathyroidism with visceral manifestations, confirmed by laboratory study following the clinical recommendations algorithms, but instrumental diagnosis, in this case, required an additional examination to clarify the parathyroid adenoma localization. Further follow-up of the patient and conservative treatment methods are discussed.

Keywords: primary hyperparathyroidism, symptomatic, hypercalcemia, hypophosphatemia, parathyroid hormone, nephrolithiasis.

For citation: Demidova T.Yu., Kishkovich Yu.S. Symptomatic primary hyperparathyroidism. Clinical case. RMJ. 2019;12:29–32.