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Atypical Parathyroid Adenoma Complicated with Protracted Hungry Bone Syndrome after Surgery: A Case Report and Literature Review

Hungry Bone Syndrome refers to the severe and prolonged hypocalcemia and hypophosphatemia, following parathyroidectomy in patients with hyperparathyroidism. We present the case of an eighteen-year-old woman with a four-year history of hyporexia, polydipsia, weight loss, growth retardation, and poor...

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Autores principales: Juárez-León, Óscar Alfredo, Gómez-Sámano, Miguel Ángel, Cuevas-Ramos, Daniel, Almeda-Valdés, Paloma, López-Flores A La Torre, Manuel Alejandro, Reza-Albarrán, Alfredo Adolfo, Gómez-Pérez, Francisco Javier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4660009/
https://www.ncbi.nlm.nih.gov/pubmed/26640724
http://dx.doi.org/10.1155/2015/757951
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author Juárez-León, Óscar Alfredo
Gómez-Sámano, Miguel Ángel
Cuevas-Ramos, Daniel
Almeda-Valdés, Paloma
López-Flores A La Torre, Manuel Alejandro
Reza-Albarrán, Alfredo Adolfo
Gómez-Pérez, Francisco Javier
author_facet Juárez-León, Óscar Alfredo
Gómez-Sámano, Miguel Ángel
Cuevas-Ramos, Daniel
Almeda-Valdés, Paloma
López-Flores A La Torre, Manuel Alejandro
Reza-Albarrán, Alfredo Adolfo
Gómez-Pérez, Francisco Javier
author_sort Juárez-León, Óscar Alfredo
collection PubMed
description Hungry Bone Syndrome refers to the severe and prolonged hypocalcemia and hypophosphatemia, following parathyroidectomy in patients with hyperparathyroidism. We present the case of an eighteen-year-old woman with a four-year history of hyporexia, polydipsia, weight loss, growth retardation, and poor academic performance. The diagnostic work-up demonstrated primary hyperparathyroidism with hypercalcemia of 13.36 mg/dL, a PTH level of 2551 pg/mL, bone brown tumors, and microcalcifications within pancreas and kidneys. Neck ultrasonography revealed a parathyroid adenoma of 33 × 14 × 14 mm, also identified on (99)Tc-sestamibi scan. Bone densitometry showed decreased Z-Score values (total lumbar Z-Score of −4.2). A right hemithyroidectomy and right lower parathyroidectomy were performed. Pathological examination showed an atypical parathyroid adenoma, of 3.8 g of weight and 2.8 cm in diameter. After surgery she developed hypocalcemia with tetany and QTc interval prolongation. The patient required 3 months of oral and intravenous calcium supplementation due to Hungry Bone Syndrome (HBS). After 42 months, she is still under oral calcium. Usually HBS lasts less than 12 months. Therefore we propose the term “Protracted HBS” in patients with particularly long recovery of 1 year. We present a literature review of the diagnosis, pathophysiology, and treatment of HBS.
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spelling pubmed-46600092015-12-06 Atypical Parathyroid Adenoma Complicated with Protracted Hungry Bone Syndrome after Surgery: A Case Report and Literature Review Juárez-León, Óscar Alfredo Gómez-Sámano, Miguel Ángel Cuevas-Ramos, Daniel Almeda-Valdés, Paloma López-Flores A La Torre, Manuel Alejandro Reza-Albarrán, Alfredo Adolfo Gómez-Pérez, Francisco Javier Case Rep Endocrinol Case Report Hungry Bone Syndrome refers to the severe and prolonged hypocalcemia and hypophosphatemia, following parathyroidectomy in patients with hyperparathyroidism. We present the case of an eighteen-year-old woman with a four-year history of hyporexia, polydipsia, weight loss, growth retardation, and poor academic performance. The diagnostic work-up demonstrated primary hyperparathyroidism with hypercalcemia of 13.36 mg/dL, a PTH level of 2551 pg/mL, bone brown tumors, and microcalcifications within pancreas and kidneys. Neck ultrasonography revealed a parathyroid adenoma of 33 × 14 × 14 mm, also identified on (99)Tc-sestamibi scan. Bone densitometry showed decreased Z-Score values (total lumbar Z-Score of −4.2). A right hemithyroidectomy and right lower parathyroidectomy were performed. Pathological examination showed an atypical parathyroid adenoma, of 3.8 g of weight and 2.8 cm in diameter. After surgery she developed hypocalcemia with tetany and QTc interval prolongation. The patient required 3 months of oral and intravenous calcium supplementation due to Hungry Bone Syndrome (HBS). After 42 months, she is still under oral calcium. Usually HBS lasts less than 12 months. Therefore we propose the term “Protracted HBS” in patients with particularly long recovery of 1 year. We present a literature review of the diagnosis, pathophysiology, and treatment of HBS. Hindawi Publishing Corporation 2015 2015-11-12 /pmc/articles/PMC4660009/ /pubmed/26640724 http://dx.doi.org/10.1155/2015/757951 Text en Copyright © 2015 Óscar Alfredo Juárez-León et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Juárez-León, Óscar Alfredo
Gómez-Sámano, Miguel Ángel
Cuevas-Ramos, Daniel
Almeda-Valdés, Paloma
López-Flores A La Torre, Manuel Alejandro
Reza-Albarrán, Alfredo Adolfo
Gómez-Pérez, Francisco Javier
Atypical Parathyroid Adenoma Complicated with Protracted Hungry Bone Syndrome after Surgery: A Case Report and Literature Review
title Atypical Parathyroid Adenoma Complicated with Protracted Hungry Bone Syndrome after Surgery: A Case Report and Literature Review
title_full Atypical Parathyroid Adenoma Complicated with Protracted Hungry Bone Syndrome after Surgery: A Case Report and Literature Review
title_fullStr Atypical Parathyroid Adenoma Complicated with Protracted Hungry Bone Syndrome after Surgery: A Case Report and Literature Review
title_full_unstemmed Atypical Parathyroid Adenoma Complicated with Protracted Hungry Bone Syndrome after Surgery: A Case Report and Literature Review
title_short Atypical Parathyroid Adenoma Complicated with Protracted Hungry Bone Syndrome after Surgery: A Case Report and Literature Review
title_sort atypical parathyroid adenoma complicated with protracted hungry bone syndrome after surgery: a case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4660009/
https://www.ncbi.nlm.nih.gov/pubmed/26640724
http://dx.doi.org/10.1155/2015/757951
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