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Case Reports
. 2024 Sep 25;16(9):e70179.
doi: 10.7759/cureus.70179. eCollection 2024 Sep.

Tertiary Hyperparathyroidism: A Case Report

Carolina Fernandes  1 , Vera Vieira  2 , Cláudia Diogo  1 , Ana Catarina Domingues  1 , Ana Rodrigues  1
Affiliations
Case Reports

Tertiary Hyperparathyroidism: A Case Report

Carolina Fernandes et al. Cureus. .

Abstract

Tertiary hyperparathyroidism is characterized by increased parathyroid hormone (PTH) secretion that appears after prolonged secondary hyperparathyroidism, leading to the onset of hypercalcemia. The parathyroid glands are found to undergo hyperplastic or adenomatous changes and act autonomously with increased parathormone secretion not suppressed by feedback control. This entity is commonly associated with long-term secondary hyperparathyroidism states, such as chronic kidney disease, renal transplantation, and gastrointestinal malabsorption. The authors describe the case of a 50-year-old female with a history of biliopancreatic diversion surgery, renal lithiasis with recurrent obstructive pyelonephritis, and a work accident with significant limitation of mobility. She was referred to hospital consultation for a pathological fracture of the dorsal vertebra in the context of tertiary hyperparathyroidism due to long-term gastrointestinal malabsorption.

Keywords: adenoma; bariatric surgery; hypercalcemia; malabsorption; tertiary hyperparathyroidism.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Sagittal view of dorsolumbar magnetic resonance imaging
Arrows: compressive pathological fractures
Figure 2
Figure 2. Parathyroid gland scintigraphy
Arrow: right inferior parathyroid gland adenoma
See this image and copyright information in PMC

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