Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Primary Hyperparathyroidism Presumably Caused by Chronic Parathyroiditis Manifesting from Hypocalcemia to Severe Hypercalcemia
Sumiko FURUTO-KATOShigeru MATSUKURAMakoto OGATANobuyuki AZUMAToshiaki MANABEChohei SHIGENORyo ASATOKiyoshi TANAKAYasato KOMATSUKazuwa NAKAO
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JOURNAL OPEN ACCESS

2005 Volume 44 Issue 1 Pages 60-64

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Abstract

A 67-year-old woman who presented with hypocalcemia compatible with idiopathic hypoparathyroidism gradually changed into a state of primary hyperparathyroidism. The left upper parathyroid gland, which was larger and harder than other glands, was resected. Despite the operation, hypercalcemia and high levels of intact PTH persisted. Six weeks later total parathyroidectomy was done to induce remission. The resected gland in the first operation had clusters of lymphoid follicles with germinal centers indicating a chronic autoimmune inflammation. This case suggests a transition from hypoparathyroidim to hyperparathyroidism associated with chronic parathyroiditis, possibly by a mechanism analogous to that observed in chronic thyroiditis.

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© 2005 by The Japanese Society of Internal Medicine
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