title: Primary hyperparathyroidism presumably caused by chronic parathyroiditis manifesting from hypocalcemia to severe hypercalcemia.
abstract: 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.
authors.affiliation: Kishiwada City Hospital, Osaka.
authors.forename: Sumiko
authors.initials: S
authors.lastname: Furuto-Kato
authors.forename: Shigeru
authors.initials: S
authors.lastname: Matsukura
authors.forename: Makoto
authors.initials: M
authors.lastname: Ogata
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Azuma
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Manabe
authors.forename: Chohei
authors.initials: C
authors.lastname: Shigeno
authors.forename: Ryo
authors.initials: R
authors.lastname: Asato
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yasato
authors.initials: Y
authors.lastname: Komatsu
authors.forename: Kazuwa
authors.initials: K
authors.lastname: Nakao
mesh_terms: 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
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium