• Vol. 30 No. 1, 66–70
  • 15 January 2001

A Case Report of Primary Hyperparathyroidism with Severe Bony Involvement and Nephrolithiasis



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'Introduction: Although the majority of patients with primary hyperparathyroidism have a relatively asymptomatic benign disorder, there are patients who have a more aggressive disorder.

Clinical Picture: We report a case of primary hyperparathyroidism presenting during pregnancy complicated by antepartum haemorrhage and severe prematurity. The diagnosis was made postpartum, when her problems rapidly progressed to result in severe neuromuscular weakness, bilateral pathological hip fractures as well as nephrolithiasis.

Treatment: Surgical parathyroidectomy was performed. The underlying lesion was a large solitary parathyroid adenoma with cystic elements.

Conclusion: Primary hyperparathyroidism is not an innocuous disease and can result in severe morbidity if left untreated.

Primary hyperparathyroidism is said to have evolved from a disease of “bones, stones and groans”, to one that is largely asymptomatic with a relatively benign course in the majority of patients. In a 1981 study, the incidence of radiologically detectable bone disease was found in 24% of patients but this complication is now considered rare.

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