PRIMARY HYPERPARATHYROIDISM BY ADENOMA OF PARATHYROID: CASE REPORT

Abstract

Introduction: Primary Hyperparathyroidism (PHPT) is a relatively common endocrine disorder and is the most common cause of hypercalcemia in outpatients (MARQUES; MOREIRA, 2020). Its diagnosis is based on high dosages of PTH levels in hypercalcemic patients (DELGADO-GOMEZ et al., 2020). The most frequent biochemical profile is that of hypercalcemia, hypophosphatemia and high levels of parathyroid hormone (MARQUES; MOREIRA, 2020). PHPT is more common in women than in men and increases with aging in both sexes (MARQUES; MOREIRA, 2020). The vast majority of cases (80 – 85%) are caused by an isolated adenoma of a parathyroid gland and only 2% by parathyroid carcinoma (XAVIER, 2020). Clinical manifestations are due to the effects of increased PTH secretion and increased serum calcium value, and may present with nephrolithiasis, bone disease, gastrointestinal manifestations, neuropsychiatric manifestations, and nonspecific symptoms, which can be attributed to hypercalcemia such as anorexia, nausea , constipation, polydipsia and polyuria (MARQUES; MOREIRA, 2020). Parathyroidectomy is the gold standard treatment (XAVIER, 2020). The reduction of serum PTH values by 50% or more compared to previous levels suggests that the parathyroidectomy was successful and serum calcium returns to normal value after 24 – 72 hours (RODRIGUEZ et al., 2021). If surgery cannot be performed, clinical management is indicated (GUZMAN; ARIBA, 2021).