International Journal of Clinical Case Reports 2016, Vol.6, No.31, 1-2
1
A Letter Open Access
A Hidden Secondary Hyperparathyroidism: A Case Report
M. A. Amani
1,
, S. Miraoui
1
, M. J. Yousfi
2
1 Department of Endocrinology, 1st November 1954 University Hospital of Oran, Algeria
2 Department of Urology, 1st November 1954 University Hospital of Oran, Algeria
Corresponding author email
International Journal of Clinical Case Reports 2016, Vol.6, No.31 doi
Received: 06 Nov., 2016
Accepted: 12 Dec., 2016
Published: 13 Dec., 2016
This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article
:
Amani M.A., Miraoui S. and Yousfi M.J., 2016, A Hidden Secondary Hyperparathyroidism: A Case Report, International Journal of Clinical Case Reports,
6(31): 1-2 (doi
Abstract
The secondary hyperparathyroidism is defined by an elevated parathyroid hormone (PTH) secondary to a decrease in
calcemia. We report the case of a 15-year old female, followed for 3 years at the nephrology department for a nephrocalcinosis and
which was addressed to us for the suspicion of a primary hyperparathyroidism. We noted in her personal history renal lithiasis.
The physical examination found a tooth dystrophy with decalcified teeth and diffuse bone pain. First blood tests: calcemia: 85mg/L
(80-105), phosphoremia: 55mg/L (40-70) and PTH: 147.6pg/ml high (15-65). Second blood tests: calcemia: 90.85mg/L (81-104),
phosphoremia: 40.14mg/L (25-46) and PTH: 169.4pg/ml high (15-65). The blood tests were completed with a dosage of
25-hydroxy-vitamin D: 11ng/ml (deficiency), 24 hours calciuria: 198mg/24h (4.4mg/Kg/24h), high. The renal ultrasound showed a
nephrocalcinosis. The patient received a vitamin D treatment than the normalizing of the vitamin D was obtained (30.53ng/ml) and
PTH too (56pg/ml, standards: 15-80). The diagnosis of a primary hyperparathyroidism will be retained after eliminating a secondary
hyperparathyroidism.
Keywords
Secondary hyperparathyroidism; Hypercalcemia; Vitamin D; Nephrocalcinosis
1 Introduction
The secondary hyperparathyroidism is defined by an elevated parathyroid hormone (PTH) secondary to a decrease
in calcemia.
2 Case Report
We report the case of a 15-year old female, followed for 3 years at the nephrology department for a
nephrocalcinosis and which was addressed to us for the suspicion of a primary hyperparathyroidism. We noted in
her personal history renal lithiasis and in her family history a deceased aunt following a nephropathy with
repeated renal lithiasis.
The physical examination found a tooth dystrophy with decalcified teeth and diffuse bone pain.
Biology
First blood tests: calcemia: 85mg/L (80-105), phosphoremia: 55mg/L (40-70) and PTH: 147.6pg/ml high (15-65).
Second blood tests: calcemia: 90.85mg/L (81-104), phosphoremia: 40.14mg/L (25-46) and PTH: 169.4pg/ml high
(15-65).
Albuminemia: 41.09g/L (35-50), magnesemia: 2.56mg/dl (1.7-2.8), urea: 0.13g/L (0.1-0.5), creatininemia:
6.02mg/L (6-12).
The blood tests were completed with a dosage of 25-hydroxy-vitamin D: 11ng/ml (deficiency), 24 hours calciuria:
198mg/24h (4.4mg/Kg/24h), high. The renal ultrasound showed a nephrocalcinosis (fig: 1).
The patient received a vitamin D treatment than the normalizing of the vitamin D was obtained (30.53ng/ml) and
PTH too (56pg/ml, standards: 15-80). Because of the hypercalciuria, a gas analysis was performed by the
