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DOI: 10.1055/s-2007-992155
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
A Case of Parathyroid Carcinoma with Severe Hungry Bone Syndrome and Review of Literature
Publication History
received 12.07.2007
first decision 02.10.2007
accepted 11.10.2007
Publication Date:
20 December 2007 (online)
Abstract
We present a 45 year old female who was initially seen by Rheumatologist with long standing knee pain affecting her mobility. She was found to be severely hypercalcaemic and exhibited features suggestive of parathyroid carcinoma (palpable neck mass, extremely high parathyroid hormone, high alkaline phosphatase, concomitant presence of renal disease and skeletal involvement). Hence she was referred for parathyroidectomy.
Postoperatively she developed profound hypocalcaemia with markedly raised serum alkaline phosphatase, requiring intensive intravenous calcium and oral vitamin D supplements, consistent with the development of hungry bone syndrome (HBS).
HBS is a complication of parathyroid surgery where the correction of primary hyperparathyroidism is associated with rapid bone remineralisation, causing severe and prolonged hypocalcaemia.
HBS is relatively rare but has to be considered in the differential diagnosis of postoperative hypocalcaemia particularly in severe cases.
In the current report, we discuss pathogenesis, clinical course and management of HBS.
Key words
hyperparathyroidism - hungry bone syndrome - parathyroid carcinoma - parathyroidectomy - postoperative management
References
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Correspondence
Dr. M.S. Rathi
Department of Endocrinology
Leeds General Infirmary
Great George Street
LEEDS
LS1 3EX
United Kingdom
Phone: +44/113/392 66 93
Fax: +44/113/392 31 50
Email: manjusharathi@hotmail.com