title: Normocalcemic primary hyperparathyroidism with fractures.
abstract: Normocalcemic primary hyperparathyroidism is an uncommon condition usually found among patients with urinary stones. To the best of our knowledge, this is the first case of a patient with normocalcemic primary hyperparathyroidism presenting with bilateral femoral neck fracture. A 45-year-old man had pain both hip joints and limping in for several months. Vertical fractures of bilateral femoral necks were found by radiographs. Laboratory findings showed a normal value of total serum calcium but elevated serum ionized calcium. Serum parathyroid hormone and alkaline phosphatase levels were elevated. The patient was treated with subtrochanteric valgus osteotomy fixed with a dynamic hip screw and total parathyroidectomy. Histopathologic examination showed hyperplasia of the parathyroid glands. At 1-year follow-up, the patient was doing well clinically.
authors.affiliation: Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. w62102@ms8.hinet.net
authors.forename: Po-Hui
authors.initials: PH
authors.lastname: Wu
authors.forename: Ching-Jen
authors.initials: CJ
authors.lastname: Wang
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D002118:Calcium / Q000097:blood; D002968:Clavicle / Q000293:injuries; D005265:Femoral Neck Fractures / Q000097:blood / Q000209:etiology* / Q000601:surgery; D005269:Femur / Q000601:surgery; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000150:complications* / Q000601:surgery; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000209:etiology*; D010027:Osteotomy; D010280:Parathyroid Glands / Q000473:pathology; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D012253:Rib Fractures / Q000209:etiology
chemical_list: D010281:Parathyroid Hormone; D000469:Alkaline Phosphatase; D002118:Calcium