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Kidney failure due to primary hyperparathyroidism – A rare case of late diagnosis

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High blood calcium over a number of years can cause kidney failure (renal failure). Nephrocalcinosis (calcification of the kidney) is a completely avoidable complication of hyperparathyroidism. Our days nephrocalcinosis is a very rare presentation of hyperparathyroidism due to the modern diagnostic technics and also the non-limitation in analyzing the phospho-calcic balance. We present the case of a 71 years old man with a 12 years of renal failure history, apparently idiopathic.
We must mention that the patient hadn’t been in a hospital for the last 5 years. He was diagnosed first with hypercalcemia with hypophosphatemia and addressed to the endocrinologist. Here we diagnosed the primary hyperparathyroidism, the patient had very high PTH (1036ng ml NV=15-62), wich raised the supposition of malignant tumor of the parathyroid, the patient underwent fine-needle biopsy of the detected tumor on the right inferior parathyroid that infirmed the diagnosis. He had a low vitamin D which determined the high value of PTH along with the primary tumor that judging by its dimensions and long symptomatology history had been present for at least 10 years. The deficit of vitamin D may be the cause of the late diagnosis of primary hyperparathyroidism knowing that its deficit may mask the hypercalcemia. The patient underwent surgery for the parathyroid adenoma with good evolution postoperatively and normalization of the phospho-calcic profile and value of PTH.

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