Endocrine Abstracts

Introduction: Persistent hypocalcemia after surgery for severe hyperparathyroidism are not uncommon and may be secondary to transient or permanent hypoparathyroidism but may also be due to bone pathology.

Observation: Patient of 44 years old was hospitalized for fractures of the pelvis, and shaft of left femur, spontaneous without trauma turned out. Laboratory tests shows severe hypercalcaemia to 156 mg/l, serum phosphorus at 22 mg/l, elevation of PTH to 1150 pg/ml and proper renal function with a serum creatinine to 8 mg/ml. PAL is increased to 709 U/l.

A spot of médiastinal fixation compatible with ectopic parathyroid adenoma was seen on the MIBI scintigraphy with several brown tumors. Ectopic mediastinal parathyroidectomy was made after medical preoperative treatment with bisphosphonates, vitamin D and active metabolite of vitamin D.

In postoperative period a severe hypocalcemia reaching 65 mg/l at the fifth day was observed, the PTH was (9.9 pg/ml) and PAL are increased to 560 U/l with a lowered serum phosphorus.

The difficulty of standardization of serum calcium despite supplementation of calcium element and 1 alpha and vitamin D, high PAL and the presence of diffuse bone lesions guide to The diagnosis of HBS.

Conclusion: HBS is a heightened greed bones for calcium. It occurs in situations of demineralization and intense bone remodeling.