A rare cause of hypercalcemia: two cases of parathyroid adenoma

Abstract

Hypercalcemia is a rare but serious metabolic condition that may lead to end-organ damage. Primary hyperparathyroidism is a rare disease in children and adolescents and parathyroid adenoma is the most common cause. Most of patients are clinically symptomatic and may present signs or symptoms of hypercalcemia. The aim of this report is to describe two case of hypercalcemia due to parathyroid adenoma presenting with different clinical findings. 14 years old male patient with abdominal pain, vomiting and nausea were diagnosed with acute pancreatitis. His laboratory findings were elevated amylase and lipase levels, hyperglycemia, hypercalcemia and hyperparathyroidism. Parathyroid scintigraphy showed the presence of an adenoma. Normocalcemia was provided with pamidronate and hyperglycemia was treated with insulin. Adenoma excision was performed after acute pancreatitis was recovered with replacement therapy. After the surgery, diabetes mellitus persisted and he had a hungry bone syndrome. Other patient was a 12-year-old male patient presented with complaints of anorexia, weakness, constipation and nausea. He had hypercalcemia, hypophosphatemia and hyperparathyroidism. Parathyroid adenoma was detected with parathyroid scintigraphy. Adenoma excision was performed and postoperatively he had a hungry bone syndrome. Hypercalcemia associated with primary hyperparathyroidism is rare but generally symptomatic in children and adolescents. It should be kept in mind in the differential diagnosis of hypercalcemia and patients should be protected from complications and permanent damage.