[Primary hyperparathyroidism. An alternative to the surgery].
Primary hyperparathyroidism is caused by an adenoma/hyperplasia in the parathyroid glands in which hypercalcemia is mainly due to an increased secretion of parathormone (PTH). The only definitive treatment is surgery. There are some patients at high surgical risk or who refuse surgery, and whose hypercalcemia cannot be controlled with conventional medical therapy such as hydration, diuretics and/or oral biphosphonates. We suggest the use of two drugs indicated for the treatment of hypercalcemia of other etiologies: zoledronic acid, a parenteral bisphosphonate, and cinacalcet, a calcimimetic agent that reduces PTH secretion. We present the case of a woman with hypercalcemia due to primary hyperparathyroidism caused by an adenoma, who was treated with both drugs.
Díaz Guardiola
Patricia
P
Servicio de Endocrinología y Nutrición, Hospital Universitario de Getafe, Madrid, España. patricia.diaz.guardiola@gmail.com
Vega Piñero
Belén
B
Alameda Hernando
Carmen
C
Pavón de Paz
Isabel
I
Iglesias Bolaños
Paloma
P
Guijarro de Armas
Guadalupe
G
D000236:Adenoma / Q000150:complications*; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery; D002277:Carcinoma / Q000601:surgery; D002292:Carcinoma, Renal Cell / Q000503:physiopathology; D000069449:Cinacalcet; D015897:Comorbidity; D000075202:Contraindications; D004164:Diphosphonates / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005440:Fluid Therapy; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy* / Q000209:etiology; D049950:Hyperparathyroidism, Primary / Q000209:etiology*; D007093:Imidazoles / Q000627:therapeutic use*; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000503:physiopathology; D009281:Naphthalenes / Q000627:therapeutic use*; D010282:Parathyroid Neoplasms / Q000150:complications*; D016105:Parathyroidectomy; D016312:Treatment Refusal; D000077211:Zoledronic Acid
D004164:Diphosphonates; D007093:Imidazoles; D009281:Naphthalenes; D000077211:Zoledronic Acid; D005665:Furosemide; D000069449:Cinacalcet