Spuriously High Levels in a Patient After Total Parathyroidectomy with Forearm Auto-Transplantation

Abstract

Primary hyperparathyroidism is an endocrine disease characterized by hypercalcemia-specific symptoms and signs with elevated parathormone (PTH). It can be accompanied by one or more adenomas, hyperplasia, or rarely parathyroid carcinoma. Parathyroidectomy is commonly used for treatment. Post-operative hypocalcemia or recurrent hyperplasia may develop so patients should be closely monitored. In this case report, a patient with isolated elevation of PTH levels, 2 years after total parathyroidectomy and forearm auto-transplantation, is presented. Detection of spuriously elevated PTH levels in the transplanted forearm may lead to misdiagnosis of recurrent hyperparathyroidism. If PTH levels remain high in patients with forearm auto-transplantation, it is essential to measure PTH levels in both arms.

Keywords

• forearm auto-transplantation
• parathyroid adenoma
• primary hyperparathyroidism.