Primary hyperparathyroidism presumably caused by chronic parathyroiditis manifesting from hypocalcemia to severe hypercalcemia.
A 67-year-old woman who presented with hypocalcemia compatible with idiopathic hypoparathyroidism gradually changed into a state of primary hyperparathyroidism. The left upper parathyroid gland, which was larger and harder than other glands, was resected. Despite the operation, hypercalcemia and high levels of intact PTH persisted. Six weeks later total parathyroidectomy was done to induce remission. The resected gland in the first operation had clusters of lymphoid follicles with germinal centers indicating a chronic autoimmune inflammation. This case suggests a transition from hypoparathyroidim to hyperparathyroidism associated with chronic parathyroiditis, possibly by a mechanism analogous to that observed in chronic thyroiditis.
Furuto-Kato
Sumiko
S
Kishiwada City Hospital, Osaka.
Matsukura
Shigeru
S
Ogata
Makoto
M
Azuma
Nobuyuki
N
Manabe
Toshiaki
T
Shigeno
Chohei
C
Asato
Ryo
R
Tanaka
Kiyoshi
K
Komatsu
Yasato
Y
Nakao
Kazuwa
K
D000368:Aged; D002118:Calcium / Q000097:blood; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000150:complications; D006961:Hyperparathyroidism / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D006996:Hypocalcemia / Q000150:complications; D007249:Inflammation; D010279:Parathyroid Diseases / Q000150:complications* / Q000473:pathology; D010280:Parathyroid Glands / Q000473:pathology; D010281:Parathyroid Hormone / Q000097:blood
D010281:Parathyroid Hormone; D002118:Calcium