Special case of primary hyperparathyroidism late diagnosis

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.

Keywords

• primary hyperparathyroidism
• hypercalcemia
• parathyroid hormone
• parathyroid adenoma
• case report