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Primary hyperparathyroidism with nephrolithiasis in a menopausal woman with regard to a case

Abstract:

Introduction: Primary hyperparathyroidism consists in the increased levels of parathyroid hormone (PTH), the clinical picture is characterized by symptoms of hypercalcemia, nephrolithiasis, bone mineral disease, neuromuscular symptoms, there are also asymptomatic presentations; nephrolithiasis occurs in 4-15% of patients, and the disease usually occurs in women at menopause. Case Report: Female patient, 65 years of age who presented with a clinical picture characterized by lower abdominal pain of mild intensity that radiates to lower back accompanied by dysuria, polyuria, dark urine, urgency and headache of moderate intensity, the patient reported recurrence of this symptoms. Her lab tests reveal this information calcemia of 12 mg/dl, 310 mg/24 hour urine calcium, serum phosphorus 2.1 mg/dl, phosphorus 150 mg/24 hours in urine, magnesium 2.2 mg/dl, PTH 120 pg/ml which reveal the diagnosis of primary hyperparathyroidism. Her renal ultrasound showed bilateral kidney stones and bone densitometry at the lumbar spine shows osteopenia and osteoporosis in femur head with T score-1 and-2 respectively. Other tests are ordered and alendronate and parathyroid surgery is recommended. Conclusions: The best treatment for the patient would be the parathyroidectomy, however still lacks examinations necessary for the treatment of both hyperparathyroidism and renal lithiasis, its necessary parathyroid scintigraphy and computed tomography.