Modern diagnosis of primary hyperparathyroidism. Clinical case

• Olga P. P'yanykh

AbstractThe peculiarity of the presented clinical case is the absence of pronounced clinical symptoms of primary hyperparathyroidism and the complexity of the topical diagnosis of the disease, leading to the progression of osteoporosis. Detection of parathyroid adenoma localization with the help of SPECT/CT followed by radical treatment led to the absence of postoperative complications and positive dynamics of the disease.

Keywords:primary hyperparathyroidism, parathyroid hormone, hypercalcemia, osteoporosis, SPECT/CT

References

1. AACE/AAES position statement on the diagnosis and management of primary hyperparathyreoidism. Endocr Pract. 2005; 11: 49–54.

2. Endocrinology: National guidelines. 2nd ed., revised and additional. In: I.I. Dedov (ed.). Moscow: GEOTAR-Media, 2016. (in Russian)

3. Yu N., Donnan P.T., Murphy M.J., Leese P. Epidemiology of primary hyperparathyroidism in tayside, Scotland, UK. Clin Endocrinol. 2009; 71: 485–93.

4. Chiavistelli S, Bilezikian J. Does calcium intake influence the development of primary hyperparathyroidism? IBMS BoneKEy. 2013; 10: 314.

5. De Lucia F., Minisola S., Romagnoli E., et al. Effect of gender and geographic location on the expression of primary hyperparathyroidism. J Endocrinol Invest. 2013; 36: 123–6.

6. Dedov I.I., Mel’nichenko G.A., Mokrysheva N.G., Rozhinskaya L.Ya., et al. Clinical Guidelines. Primary Hyperparathyroidism: Clinic, Diagnostics, Differential Diagnostics, Methods of Treatment. Moscow: FGBU «Endokrinilogicheskiy nauchniy tsentr» Minzdrava Rossii, 2016. (in Russian)

7. Silverberg S.J., Clarke B.L., Peacock M., Bandeira F., et al. Current issues in the presentation of asymptomatic primary hyperparathyroidism: Proceedings of the Fourth International Workshop. J Clin Endocrinol Metab. 2014;99 (10): 3561–9. doi: 10.1210/jc.2014-1413

8. Rozhinskaya L.Ya., Mokrysheva N.G., Kuznetsov N.S. Algorithms for Examination and Treatment of Patients in Endocrinology: Guidelines of the Federal State University ENC MOH. Part II. Hyperparathyroidism. Moscow, 2009. (in Russian)

9. Antsiferov M.B. Markina N.V. Modern approaches to the diagnosis and treatment of primary hyperparathyroidism. Russkiy meditsinskiy zhurnal [Russian Medical Journal]. 2014; (13): 974. (in Russian)

10. Whitson B.A., Broadie T.A. Preoperative ultrasound and nuclear medicine studies improve the accuracy in localization of adenoma in hyperparathyroidism. Surg Today. 2008; 38: 222–6.

11. Johnson N.A., Tublin M.E., Ogilvie J.B. Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism. AJR Am J Roentgenol. 2007; 188: 1706–15.

12. Kasai E.T., da Silva J.W., Mandarim de Lacerda C.A., et al. Parathyroid glands: combination of sestamibi-(99m)Tc scintigraphy and ultrasonography for demonstration of hyperplasic parathyroid glands. Rev Esp Med Nucl. 2008; 27: 8–12.

13. Fomin D.K., Borisova O.A., Nazarov A.A., Pyatnitsky I.A. the Role of single-photon emission computed tomography combined with computed tomography in the diagnosis of parathyroid pathology. Vestnik Rossiyskogo nauchnogo tsentra rentgenoradiologii Minzdrava Possii [Bulletin of the Russian Scientific Center of Roentgenoradiology of the Ministry of Health of Russia]. 2014; (14): 5. (in Russian)

14. Eslamy H.K., Ziessman H.A. Parathyroid scintigraphy in patients with primary hyperparathyroidism: 99mTc sestamibi SPECT and SPECT/CT. Radiographics. 2008; 28 (5): 1461–76.

15. Lavely W.C., Goetze S., Friedman K.P., et al. Comparison of SPECT/CT, SPECT, and planar imaging with single- and dual-phase 99mTc-sestamibi parathyroid scintigraphy. J Nucl Med. 2007; 48: 1084–9.

16. Dowthwaite S.A., Young J.E., Pasternak J.D., Yoo J. Surgical management of primary hyperparathyroidism. J Clin Densitom. 2013; 16 (1): 48–53.

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)