A case of severe hyperparathyroidism in clinical practice. Case report
- Authors: Biryukova E.V.1,2, Shinkin M.V.2, Podachina S.V.1,2, Feidorov I.Y.2, Mikheeva O.M.2, Zvenigorodskaya L.A.2, Malkina N.A.2, Synkova D.A.2
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Affiliations:
- Russian University of Medicine
- Loginov Moscow Clinical Scientific Center
- Issue: Vol 95, No 12 (2023)
- Pages: 1185-1191
- Section: Clinical notes
- URL: https://journals.rcsi.science/0040-3660/article/view/258747
- DOI: https://doi.org/10.26442/00403660.2023.12.202483
- ID: 258747
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Abstract
Disorders of the mineral balance often determine the symptoms, the severity of the course and the prognosis of many diseases. Primary hyperparathyroidism (PHPT) is a common endocrine disease caused by increased secretion of parathyroid hormone as a result of primary damage to the parathyroid glands. Diagnosis of PHPT is often difficult. Clinical signs of PHPT appear months or years after the onset of the disease, however, the presence of hypercalcemia serves as an early indication of the disease of the thyroid gland. Often, patients are observed for a long time by related specialists (rheumatologists, traumatologists-orthopedists, oncologists), which gives rise to a lot of problems consisting in the lack of adequate treatment and its result, the progression of the disease, disability, and a decrease in the quality of life. Often, patients are observed for a long time by related specialists (rheumatologists, orthopedic traumatologists, oncologists) under the “masks” of various pathologies (osteoporosis, recurrent urolithiasis, etc.), which gives rise to a lot of problems, consisting in an erroneous diagnosis, lack of adequate treatment and its result, progression of the disease, disability, and a decrease in the quality of life. Late diagnosis of PHPT leads to the development of severe complications (osteoporetic fractures, renal failure) and an increased risk of premature death. A clinical case of late diagnosis of PHPT at the stage of pronounced bone complications of the disease, which proceeded under the guise of osteoarthritis, is considered. According to the results of laboratory and instrumental studies, the following were revealed: hypercalcemia, a significant increase in the concentration of PTH, adenoma of the left lower parathyroid gland, hyperparathyroid osteodystrophy, and a decrease in bone mineral density. Surgical treatment was performed – selective parathyroidectomy with the development of hypocalcemia in the early postoperative period, which was stopped by taking calcium supplements and active vitamin D metabolites and is designed to help practitioners of various specialties to understand the issues of diagnosis of PHPT and effective care for patients.
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##article.viewOnOriginalSite##About the authors
Elena V. Biryukova
Russian University of Medicine; Loginov Moscow Clinical Scientific Center
Email: m.shinkin@mknc.ru
ORCID iD: 0000-0001-9007-4123
д-р мед. наук, проф. каф. эндокринологии и диабетологии ФГБОУ ВО «Российский университет медицины», куратор эндокринной службы ГБУЗ «МКНЦ им. А.С. Логинова»
Russian Federation, Moscow; MoscowMikhail V. Shinkin
Loginov Moscow Clinical Scientific Center
Author for correspondence.
Email: m.shinkin@mknc.ru
ORCID iD: 0000-0003-1548-1487
науч. сотр. отд. эндокринных и метаболических нарушений, врач-эндокринолог
Russian Federation, MoscowSvetlana V. Podachina
Russian University of Medicine; Loginov Moscow Clinical Scientific Center
Email: m.shinkin@mknc.ru
ORCID iD: 0000-0003-3991-1023
д-р мед. наук, доц. каф. эндокринологии и диабетологии ФГБОУ ВО «Российский университет медицины», куратор эндокринной службы ГБУЗ «МКНЦ им. А.С. Логинова»
Russian Federation, Moscow; MoscowIlia Yu. Feidorov
Loginov Moscow Clinical Scientific Center
Email: m.shinkin@mknc.ru
ORCID iD: 0000-0001-8369-5116
канд. мед. наук, науч. сотр. Центра эндокринной и метаболической хирургии
Russian Federation, MoscowOlga M. Mikheeva
Loginov Moscow Clinical Scientific Center
Email: m.shinkin@mknc.ru
ORCID iD: 0000-0002-0573-7234
д-р мед. наук, проф., зав. отд-нием диагностики и общей терапии
Russian Federation, MoscowLarissa A. Zvenigorodskaya
Loginov Moscow Clinical Scientific Center
Email: m.shinkin@mknc.ru
ORCID iD: 0000-0001-6469-1259
д-р мед. наук, проф., вед. науч. сотр. отд. эндокринных и метаболических нарушений
Russian Federation, MoscowNatalia A. Malkina
Loginov Moscow Clinical Scientific Center
Email: m.shinkin@mknc.ru
ORCID iD: 0000-0001-6090-7809
канд. мед. наук, науч. сотр. отд. эндокринной и метаболической хирургии
Russian Federation, MoscowDaria A. Synkova
Loginov Moscow Clinical Scientific Center
Email: m.shinkin@mknc.ru
ORCID iD: 0000-0003-2228-756X
науч. сотр. отд-ния патологической анатомии
Russian Federation, MoscowReferences
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