Endocrine Abstracts

Introduction: Primary hyperparathyroidism is an endocrinopathy characterized by the excessive secretion of parathyroid hormone, most commonly associated with parathyroid adenoma. The osteoarticular manifestations of hyperparathyroidism are currently exceptional. The diagnosis is most often established at the asymptomatic stage by measuring calcium levels and parathyroid hormone.

Observation: We report the case of a 67-year-old patient with a history of partially calcified right parietal meningioma, and who consulted for diffuse mechanical bone pain. A phosphocalcic balance is carried out objectifying a hypercalcemia corrected to 117 mg/l with a normal phosphoremia at 29 mg/l, a normal vitamin D and a parathyroid hormone elevated to 115 g/l. A subtraction parathyroid scintigraphy with MiBi-99mTc/Pertechnetate revealed a right lower polar parathyroid adenoma measuring 5×4×6 mm, oval, regular, hypoechoic and heterogeneous. Ablation of the parathyroid adenoma was performed in our patient with simple operative consequences and good progress.

Discussion and conclusion: Bone manifestations have become rare in hyperparathyroidism. They are characterized mainly by mechanical polyarthralgia, bone swelling or even pathological fractures. The positive diagnosis is based biologically on confirmed hypercalcemia with elevated PTH and morphologically on parathyroid scintigraphy at TC 99 m which allows visualization of the parathyroid adenoma. The treatment is surgical.