Endocrine Abstracts

JOINT2432

Parathyroid adenoma often remains undiagnosed for a relatively long time, due to the fact that bone pains and disorders of the osteomuscular system, patients seek to be resolved in other non-endocrinological problems. Case presentation: The case describes a primary thyroid adenoma in a 46-year-old patient with a two-year history of upper and lower limb pain, treated by a rheumatologist as polyathralgia without signs of improvement from therapy! In the meantime, the patient is also diagnosed with severe osteoporosis. The neurologist who was consulted for a headache during the neck examination noticed a mass in the lower part of the neck and in the ultrasound a nodule was seen for which he was referred to the endocrinologist (Figure 1). After the corresponding laboratory and imaging examinations, the patient is diagnosed with very high PTH, high calcium(Table 1) bilateral nephrocalcinosis (Figure 2), marked osteoporosis (Figure 3), fractures of the lumbar vertebrae (Figure 4), bones with diffuse osteolytic foci (Figure 5) and parathyroid adenoma, together with the expressed and characteristic clinical waddling gait from lumbar fractures and myopathy lead to primary hyperparathyroidism from parathyroid adenoma. The patient is referred for surgery and for a short time he was being fully recovered and normal gait of walking.

Key Words: Parathyroid adenoma, parathyroid hormone, hypercalcemia, bone pain

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