A rare cause of hypercalcemia : Two cases of parathyroid adenoma

Merve Nur Hepokur; Meltem Özkök; Asan Önder; Meltem Çağlar; İbrahim Ali Özemir

doi:10.19161/etd.842622

EN TR

A rare cause of hypercalcemia : Two cases of parathyroid adenoma

Abstract

Hypercalcemia is a rare but serious metabolic condition that may lead to end-organ damage. Primary hyperparathyroidism is a rare disease in children and adolescents and parathyroid adenoma is the most common cause. Most of patients are clinically symptomatic and may present signs or symptoms of hypercalcemia. The aim of this report is to describe two case of hypercalcemia due to parathyroid adenoma presenting with different clinical findings. 14 years old male patient with abdominal pain, vomiting and nausea were diagnosed with acute pancreatitis. His laboratory findings were elevated amylase and lipase levels, hyperglycemia, hypercalcemia and hyperparathyroidism. Parathyroid scintigraphy showed the presence of an adenoma. Normocalcemia was provided with pamidronate and hyperglycemia was treated with insulin. Adenoma excision was performed after acute pancreatitis was recovered with replacement therapy. After the surgery, diabetes mellitus persisted and he had a hungry bone syndrome. Other patient was a 12-year-old male patient presented with complaints of anorexia, weakness, constipation and nausea. He had hypercalcemia, hypophosphatemia and hyperparathyroidism. Parathyroid adenoma was detected with parathyroid scintigraphy. Adenoma excision was performed and postoperatively he had a hungry bone syndrome. Hypercalcemia associated with primary hyperparathyroidism is rare but generally symptomatic in children and adolescents. It should be kept in mind in the differential diagnosis of hypercalcemia and patients should be protected from complications and permanent damage.

Keywords

Hiperkalseminin nadir bir nedeni: Paratiroid adenomu olan iki olgu

Öz

Hiperkalsemi, uç organ hasarına yol açabilen nadir fakat ciddi bir metabolik bozukluktur. Primer hiperparatiroidizm, çocuklarda ve ergenlerde nadir görülür ve en sık nedeni paratiroid adenomudur. Hastaların çoğu klinik olarak hiperkalsemi semptomlarını gösterirler. Bu bildirinin amacı, farklı klinik bulgularla ortaya çıkan ve nadir görülen iki ayrı paratiroid adenomu olgusunu tanımlamaktır. Karın ağrısı, kusma ve bulantı şikayeti ile başvuran 14 yaşında erkek hastaya amilaz ve lipaz seviyelerinin yüksek olması üzerine akut pankreatit tanısı kondu. Bu duruma ek olarak hiperglisemi ve hiperkalsemisi saptanan hastanın PTH değeri oldukça yüksekti. Paratiroid sintigrafisi çekilerek paratiroid adenomu gösterildi. Hastaya pamidronat verilerek normokalsemi sağlandı ve hiperglisemi için insülin tedavisi başlandı. Replasman tedavisi ile akut pankreatit düzeldikten sonra adenom eksizyonu yapıldı. Hastanın posoperatif dönemde aç kemik sendromu gelişti ve tedavi edildi. İzlemde hastanın insülin tedavisine devam edildi. 2. olgu bulantı, iştahsızlık, halsizlik ve kabızlık şikayetleri ile başvuran 12 yaşında erkek hasta idi. Bakılan laboratuar parametrelerinde hiperkalsemi, hipofosfatemi ve hiperparatiroidi saptandı. Paratiroid sintigrafisi ile paratiroid adenomu tespit edildi. Adenom eksizyonu yapıldı ve postoperatif döenmde aç kemik sendromu gelişti. Primer hiperparatiroidizm ile ilişkili hiperkalsemi nadir olmakla birlikte çocuklarda ve ergenlerde genellikle semptomatiktir. Hastaları komplikasyonlardan ve kalıcı hasarlardan korumak için hiperkalseminin ayırıcı tanısında akılda tutulmalıdır.

Anahtar Kelimeler

References

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Case Report

Authors

Merve Nur Hepokur ^*
0000-0002-5470-1254
Türkiye

Meltem Özkök
0000-0002-2650-4819
Türkiye

Asan Önder
0000-0002-5730-3198
Türkiye

Meltem Çağlar
0000-0003-4706-6384
Türkiye

İbrahim Ali Özemir
0000-0001-8693-9358
Türkiye

Publication Date

December 22, 2021

Submission Date

December 20, 2020

Acceptance Date

April 14, 2021

Published in Issue

Year 2021 Volume: 60 Number: 4

DOI

https://doi.org/10.19161/etd.842622

IZ

https://izlik.org/JA52RE78GW

Cite

RIS / Bibtex

Vancouver

1.Merve Nur Hepokur, Meltem Özkök, Asan Önder, Meltem Çağlar, İbrahim Ali Özemir. A rare cause of hypercalcemia : Two cases of parathyroid adenoma. EJM. 2021 Dec. 1;60(4):423-6. doi:10.19161/etd.842622