Evidence Based Solving Approach in Diagnosis of Primary Hyperparathyroidism with Oral Manifestations: Report of Three Unusual Cases

Ruchi Bindal; Ajay Kumar; Harkanwal Preet Singh; Sanjiv Kumar Bansal; Aadya Sharma

doi:10.4103/0974-2727.119863

Journal of Laboratory Physicians, Table of Contents

CC BY-NC-ND 4.0 · J Lab Physicians 2013; 5(02): 113-117
DOI: 10.4103/0974-2727.119863

Case Report

Evidence Based Solving Approach in Diagnosis of Primary Hyperparathyroidism with Oral Manifestations: Report of Three Unusual Cases

Ruchi Bindal

Departments of Oral Medicine and Radiology, Gurgaon, Haryana, India

,

Ajay Kumar

Departments of Oral and Maxillofacial Pathology and Microbiology, Yamuna Institute of Dental Sciences and Research, Yamunanagar, Gurgaon, Haryana, India

,

Harkanwal Preet Singh

Departments of Oral and Maxillofacial Pathology and Microbiology, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India

,

Sanjiv Kumar Bansal

Department of Biochemistry, SGT Medical College, Hospital and Research Institute, Budhera, India

,

Aadya Sharma

Departments of Oral and Maxillofacial Surgery, SGT Dental College, Gurgaon, Haryana, India

› Author Affiliations

Abstract

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ABSTRACT

Primary hyperparathyroidism is a common condition that affects 0.3% of the general population in which excessive production of PTH is there. With changing trends it is diagnosed early and asymptomatically with the improvements in routine biochemical tests and radiological procedures. The late bony complications of the disease have therefore started to decline rapidly. The mandible is the predominantly affected site in the maxillofacial area. Maxillary involvement is rare. Here, we reported series of three cases of 30-40-year-old women with osteolytic lesions and bone resorption in maxilla or mandible. Two of presented cases demonstrated evidence of lesions in both mandible and maxilla which is a very rare event. A thorough diagnostic work-up emphasizing on biochemical and radiographic investigations were discussed. We highlighted the role of endocrinologist, oral and maxillofacial surgeons, general practitioner dentists, and radiologists in diagnosing and managing such patients.

Keywords

Endocrinologist - hyperparathyroidism - mandible - osteolytic lesions

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References

REFERENCES
1 Carlos Fabue L, Jiménez Soriano Y, Sarrión Pérez MG. Dental management of patients with endocrine disorders. J Clin Exp Dent 2010;2:e196-203.
2 Ahmad R, Hammond JM. Primary, secondary, and tertiary hyperparathyroidism. Otolaryngol Clin North Am 2004;37:701-13.
3 Heath H 3^rd, Hodgson SF, Kennedy MA. Primary hyperparathyroidism. Incidence, morbidity, and potential economic impact in a community. N Engl J Med 1980;302:189-93.
4 Pradeep PV, Jayashree B, Mishra A, Mishra SK. Systematic review of primary hyperparathyroidism in India: The past, present, and the future trends. Int J Endocrinol 2011;2011:921814.
5 Selvi F, Cakarer S, Tanakol R, Guler SD, Keskin C. Brown tumour of the maxilla and mandible: A rare complication of tertiary hyperparathyroidism. Dentomaxillofac Radiol 2009;38:53-8.
6 Soundarya N, Sharada P, Prakash N, Pradeep G. Bilateral maxillary brown tumors in a patient with primary hyperparathyroidism: Report of a rare entity and review of literature. J Oral Maxillofac Pathol 2011;15:56-9.
7 Khan A, Bilezikian J. Primary hyperparathyroidism: Pathophysiology and impact on bone. CMAJ 2000;163:184-7.
8 Movahedian B, Razavi SM, Hasheminia D, Rezaei M. Simultaneous maxillary and mandibular brown tumors in secondary hyperparathyroidism: A case report. Dent Res J 2008;5:41-5.
9 Goswami P, Sarma PK, Sethi S, Hazarika S. Extensive skeletal manifestations in a case of primary hyperparathyroidism. Indian J Radiol Imaging 2002;12:267-70.
10 Arcot R, Moorthy SN, Rao S. Hyperparathyroidism revisited-Old wine in new bottles! Indian J Endocrinol Metab 2011;15:194-7.
11 Pallan S, Khan A. Primary hyperparathyroidism: Update on presentation, diagnosis, and management in primary care. Can Fam Physician 2011;57:184-9.
12 Eastell R, Arnold A, Brandi ML, Brown EM, D′Amour P, Hanley DA, et al. Diagnosis of asymptomatic primary hyperparathyroidism: Proceedings of the third international workshop. J Clin Endocrinol Metab 2009;94:340-50.
13 Rai S, Bhadada SK, Rattan V, Bhansali A, Rao DS, Shah V. Oro-mandibular manifestations of primary hyperparathyroidism. Indian J Dent Res 2012;23:384-7.
14 Walczyk A, Szalecki M, Kowalska A. Primary hyperparathyroidism: A rare endocrinopathy in children. Two case reports. Endocrinol Pol 2011;62:346-50.
15 Piciucchi S, Barone D, Gavelli G, Dubini A, Oboldi D, Mattecui F. Primary hyperparathyroidism: Imaging to pathology. J Clin Imaging Sci 2012;2:59.
16 Pallan S, Rahman MO, Khan AA. Diagnosis and management of primary hyperparathyroidism. BMJ 2012;344:e1013.
17 Triantafillidou K, Zouloumis L, Karakinaris G, Kalimeras E, Iordanidis F. Brown tumors of the jaws associated with primary or secondary hyperparathyroidism. A clinical study and review of the literature. Am J Otolarygol 2006;27:281-6.