ECEESPE2025 ePoster Presentations Multisystem Endocrine Disorders (51 abstracts)
1Fattouma Bourguiba University Hospital, Monastir, Tunisia
JOINT3561
Introduction: Primary hyperparathyroidism (PHP) is the most common cause of hypercalcemia. Patients with autoimmune diseases can develop hypercalcemia but it is exceptionally due to PHP. The association of PHP withautoimmunedisordersisdescribedveryrarely in the literatureso far. There are only few cases of immunemediatedhyperparathyroidism, associatedwith anti-calcium- sensingreceptorautoantibodies. The exact etiology of PHP in autoimuune diseasesis not known. The underlying pathophysiology was supposed to be either a common genetic predisposition or the extension of the autoimmune process to the parathyroid glands, which is still under debate. Our objective is to report a rare case associating a background of autoimmunity and primary hyperparathyroidism.
Observation: A 44-year-old woman with medical history of lupus, vitiligo, antiphospholipid antibody syndrome, GogerotSjogrens syndrome, arterial hypertension and dyslipidaemiawas referred to our department with primary hypercalcaemia in the face of bone pain with inflammatory arthralgia and functional impotence. Her biology showed a parathyroid hormone level of 121pg/l, a calcemia of 2.92 mmol/land a vitamin D level of 18 ng/ml. A cervical ultrasound and parathyroid MIBI scintigraphywere performed, showing a left inferior parathyroid nodule measuring 21*15*13mm. A left inferior parathyroidectomywas performed with anatomophatological findings of a parathyroid adenoma and a postoperative parathyroid hormone level of 19pg/land serum calcium of 2.3mmol/l.
Conclusion: Primary hyperparathyroidism and autoimmune diseases are two serious conditions. Their association is exceptional, but it can make their management more complicated. It is important for clinicians to remember that PHP is still the most common cause of hypercalcaemia. Therefore, when hypercalcaemia occurs in autoimmune diseases, it is prudent to carry out a full investigation to determine the most appropriate treatment to avoid potential complications.
Disclosure of interest: none declared.