Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2006) 11 P69

ECE2006 Poster Presentations Clinical case reports (128 abstracts)

Primary hyperparathyroidism (PHPT): Still a cause of hypertension resistant to therapy

AP Baptista , EC Morgado , AP Silva & PL Neves


Serviço Nefrologia, Hospital Distrital Faro, Faro, Portugal.


High blood pressure is a common problem among patients in a Nephrology ward and outpatient clinic. However in those patients resistant to therapy, we must exclude a secondary cause. The authors present a case of a patient that was referred to our hospital due to complaints of headache, high blood pressure resistant to therapy (BP=240/130 mmHg), and images in renal ecography, which were compatible with enlarge left adrenal gland and left kidney atrophy. At admission the blood results were: Glucose=97 mg/dl; PlCr=2.5 mg/dl; BUN=33 mg/dl; Serum proteins=6.7 mg/dl; Na=129 mmol/l; K=4.7 mmol/l; Ca=13.8 mg/dl; P=2.8 mg/dl.

We performed a CAT scan and MRI, both of which showed: Atrophic left kidney, enlarge right kidney; left adrenal with nodular formation. With such a result, a pheocromocitoma was consider, but all studies were negative. A renogram with diuretic and captopril showed a mute left kidney and excretory defect in the right kidney, without any evidence of renovascular pathology. We review the blood results, and found Ca=13.8 mg/dl, PTH=480 pg/ml. The parathyroid cintigraphy revealed an adenoma of left inferior parathyroid gland. The diagnosis of PHPT was done and the patient was submitted to a partial parathyroidectomy.

Follow-up at 6 months: Calcium=9.4 mg/dl; PTH 124 pg/ml; BP=140/80 mmHg with 2 different drugs.

This case is an example of how, sometimes, a disturbance in calcium-phosphorus metabolism can be more than the consequence of chronic renal disease. Such changes can be related to a disorder that has an estimated prevalence on the order of 1% (PHPT). There is no consensus on the association between high levels of PTH and hypertension, although some authors associate hypertension with elevated PTH and hypercalcemia.

Volume 11

8th European Congress of Endocrinology incorporating the British Endocrine Societies

European Society of Endocrinology 
British Endocrine Societies 

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