title: Parathyroid adenoma presenting as tetraparesia.
abstract: OBJECTIVE
  Parathyroid adenomas (PA) are benign tumors. We report an unusual case of delayed diagnosis of a PA and concomitant Vitamin D deficiency presenting as tetraparesia.
  
  
  METHODS
  A 30-year-woman was admitted to our clinic with an inability to walk. Our examination revealed tetraparesia and common, severe muscular atrophy.
  
  
  RESULTS
  Laboratory investigations showed the following: creatinine phosphokinase (CK): 37 IU/L (15-130), calcium (Ca): 11.5 mg/dL (9-11), phosphorus (P): 1.5 mg/dL (2.5-5), parathyroid hormone (PTH): 736.1 pq/mL (15-65), 25-hydroxyvitamin D (25-OHvit D): 4 ng/mL (11-43), and alkaline phosphatase (ALP): 1029.5 lU (64-300). Parathyroid scintigraphy revealed PA. A year after Vitamin D replacement, the patient's neurological status and laboratory findings improved.
  
  
  CONCLUSIONS
  We suggest that the physicians always keep in mind the primary hyperparathyroidism (HPT) and concomitant Vitamin D deficiency in the differential diagnosis of hypercalcemia when facing atypical neurological symptoms such as tetraparesia.
authors.affiliation: Department of Neurology, Medical Faculty, Ataturk University, Erzurum, Turkey. asumanorhan@yahoo.com
authors.forename: Asuman Orhan
authors.initials: AO
authors.lastname: Varoglu
authors.forename: Asude
authors.initials: A
authors.lastname: Aksoy
authors.forename: Erhan
authors.initials: E
authors.lastname: Varoglu
mesh_terms: D000236:Adenoma / Q000150:complications*; D000328:Adult; D005260:Female; D006801:Humans; D010282:Parathyroid Neoplasms / Q000150:complications*; D011782:Quadriplegia / Q000209:etiology*; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications* / Q000188:drug therapy
chemical_list: D014807:Vitamin D