title: An unusual presentation of primary hyperparathyroidism: severe hypercalcemia and multiple brown tumors.
abstract: 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.
authors.affiliation: Rheumatology Department, CHU Purpan, Purpan Teaching Hospital, Place du Docteur Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Jouan
authors.forename: Laurent
authors.initials: L
authors.lastname: Zabraniecki
authors.forename: Véronique
authors.initials: V
authors.lastname: Vincent
authors.forename: Elsa
authors.initials: E
authors.lastname: Poix
authors.forename: Bernard
authors.initials: B
authors.lastname: Fournié
mesh_terms: 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