Advances in the Diagnosis and Management of Primary Hyperparathyroidism due to MEN Type 1 Syndrome

Nobecourt, Priscilla; Silva, Angelica; Perrier, Nancy D.

doi:10.1016/b978-0-323-66195-9.00010-8

Cited by 1 publication

(1 citation statement)

References 64 publications

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“…Most patients with carcinoid tumors and hyperparathyroidism have parathyroid hyperplasia or multiple parathyroid adenomas. 6 , 7 , 8 , 9 , 10 Our patient had a history of bronchial carcinoid tumors occurring in association with PHPT. She had no family history of MEN-1, her pituitary functions were normal, and she had a negative screening test result for the MEN1 gene.…”

Section: Discussionmentioning

confidence: 86%

Renal Papillary Necrosis Associated With Normocalcemic Primary Hyperparathyroidism

Ebrahim

Schmidt

Slayden

et al. 2021

AACE Clinical Case Reports

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Objectives: Renal papillary necrosis (RPN) occurring in primary hyperparathyroidism (PHPT) has not been reported. We present a 50-year-old woman who manifested RPN associated with hypercalciuria and normocalcemic PHPT. Methods: The diagnosis of RPN was based on imaging studies (ultrasound and computed tomography [CT] scan). PHPT was diagnosed with high parathyroid hormone (PTH) and high/normal serum calcium. Results: A 38-year-old woman was evaluated for hypercalcemia (serum calcium, 11.8 mg/dL; ionized calcium, 6.3 mg/dL; phosphorus, 1.8 mg/dL; intact PTH, 98 pg/mL; and 24-hour urine calcium, 543 mg). Renal ultrasound showed no nephrocalcinosis or nephrolithiasis. A parathyroid scan revealed a left parathyroid adenoma. The patient underwent parathyroidectomy, and she became normocalcemic with normal serum PTH levels postoperatively. One year later, she was diagnosed with a left-sided bronchial carcinoid tumor. Following surgery, a surveillance gallium 68 positron emission tomography/CT scan performed 2 years later was negative for metastases. Twelve years later (aged 50 years), she presented for follow-up and reported no symptoms of hypercalcemia, fractures, nephrolithiasis, history of pyelonephritis, diabetes mellitus, analgesic drug use, or hypertension. Her serum calcium level was 9.1 mg/dL, PTH level was 82 pg/mL, 25-OH vitamin D level was 34 ng/mL, and 24-hour urine calcium level was 410 mg. However, renal ultrasound showed bilateral RPN that was confirmed by a CT scan. Conclusion: RPN may be associated with hypercalciuria and normocalcemic PHPT. Additional studies with a large number of patients are needed.

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