Unusual recurrence of hypercalcemia due to concurrent parathyroid adenoma and parathyroid sarcoidosis with lymph node involvement Article

Chaychi, L, Chaidarun, S, Golding, A et al. (2010). Unusual recurrence of hypercalcemia due to concurrent parathyroid adenoma and parathyroid sarcoidosis with lymph node involvement . ENDOCRINE PRACTICE, 16(3), 463-467. 10.4158/EP09325.CR

cited authors

  • Chaychi, L; Chaidarun, S; Golding, A; Kinlaw, WB; Memoli, V; Siegel, A

authors

abstract

  • Objective: To describe a patient presenting with the rare findings of synchronous parathyroid adenoma and parathyroid sarcoidosis. Methods: We describe the clinical history, physical examination findings, laboratory values, imaging findings, and pathologic data of a man who developed recurrent severe hypercalcemia after successful parathyroidectomy. Results: A 67-year-old man had the following initial blood test results: calcium, 11.1 mg/dL (reference range, 8.5-10.6 mg/dL); albumin 4.0 g/dL (reference range, 3.2-5.2 g/dL); intact parathyroid hormone, 166 pg/mL (reference range, 10-69 pg/mL); creatinine, 1.9 mg/dL; 25-hydroxyvitamin D, 15 ng/mL (reference range, 30-80 ng/ mL); and 1,25-dihydroxyvitamin D, 44 pg/mL (reference range, 16-72 pg/mL). Chest x-ray was normal, and delayed images from a technetium Tc 99m sestamibi scan showed increased activity in the right lower pole of the thyroid. Two months after successful parathyroidectomy, the patient was admitted to the hospital with a serum calcium concentration of 17 mg/dL. Pathologic examination of the resected gland confirmed the diagnosis of parathyroid adenoma, and subsequent review disclosed the presence of noncaseating granulomas within the adenoma. Conclusions: Sarcoidosis with parathyroid involvement causing severe hypercalcemia is unique to this case. Recurrent hypercalcemia after successful resection of a parathyroid adenoma may require consideration of potential causes other than the initial diagnosis. © 2010 AACE.

publication date

  • May 1, 2010

published in

Digital Object Identifier (DOI)

start page

  • 463

end page

  • 467

volume

  • 16

issue

  • 3