Endocrine Abstracts

JOINT1211

Introduction: Primary hyperparathyroidism is endocrine disease defined by increased calcium levels and excessive level of parathyroid hormone, associated with diverse systemic complications. Most common are urinary lithiasis and osteoporosis, but calcification of soft tissue are more rarely found.

Case Presentation: A 59-year-old woman, was admitted to the hospital for surgical treatment of primary hyperparathyroidism revealed by pathologic fracture. The diagnosis of primary hyperparathyroidism was confirmed based on calcium level of 3.53 mmol/l, inappropriate PTH level of3708 ng/dL, and hypercalciuria at a level of0.15 mmol/kg/24h, complicated by severe osteoporosis with a T-score of -6.6. A right 22mm parathyroid adenoma was found by neck ultrasound and parathyroid scintigraphy. Kidney scan showed calculi in the urinary tract, along with pancreatic and adrenal calcifications, which are known and uncommon soft-tissue calcification associated with hyperparathyroidism. She didn’t have adrenal insufficiency, and there was no sign of tuberculosis. During her hospital stay, the patient’s urinary catheter was found to have calcified deposits which was relatedwith significant hypercalciuria. This is a rare but notable manifestation of PHPT, highlighting the impact of prolonged elevated calcium levels on the urinary system.

Disscussion and conclusion: This particular case demonstrates the variety of complications that primary hyperparathyroidism can cause, some of which may be unexpected. While hypercalcemia and osteoporotic fractures are common manifestations of PHPT, calcifications in the adrenal glands, pancreas, and urinary catheter are less prevalent but nonetheless important to recognize. In some cases of PHPT, calcifications have been observed, particularly in the pancreas and adrenal glands. These calcifications are the result of the long-term impact of high calcium and PTH levels on various organs. Urinary catheter calcification is uncommon but can happen as a result of high calcium levels in the urine, particularly when hypercalciuria is present. To avoid serious problems, early surgical intervention and calcium metabolism monitoring are essential. Additionally, since PHPT can present with a variety of clinical symptoms, such as fractures and unusual calcifications, it highlights the importance of being vigilant in the diagnosis process.