An unusual presentation of primary hyperparathyroidism: severe hypercalcemia and multiple brown tumors.
Primary hyperparathyroidism is common, particularly in postmenopausal women. Since the introduction of routine automated serum calcium assays and the development of assays for intact 1-84 parathyroid hormone, the diagnosis is usually made fortuitously in asymptomatic patients or during evaluation for osteoporosis. As a result, many physicians have no experience with the clinical manifestations. Here, we describe the case of a 70-year-old man with bone pain, multiple brown tumors, and severe hypercalcemia (4 mmol/L). The diagnostic pitfalls raised by these symptoms are illustrated.
Jouan
Anne
A
Rheumatology Department, CHU Purpan, Purpan Teaching Hospital, Place du Docteur Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
Zabraniecki
Laurent
L
Vincent
Véronique
V
Poix
Elsa
E
Fournié
Bernard
B
D000368:Aged; D001847:Bone Diseases / Q000175:diagnosis / Q000209:etiology*; D001859:Bone Neoplasms / Q000175:diagnosis; D003937:Diagnosis, Differential; D018212:Giant Cell Tumor of Bone / Q000175:diagnosis; D006101:Granuloma, Giant Cell / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000209:etiology*; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000175:diagnosis; D008297:Male; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging