Endocrine Abstracts

Backgroud: Primary hyperparathyroidism is the most common cause of hypercalcemia, which is associated with an increased frequency of hypertension. However, there are no data on the prevalence of primary hyperparathyroidism in patients who present with hypertension.

Clinical case: We present the case of a 40-year-old woman with a history of hypertension for ten years. In 2017 she was referred for evaluation of hypercalcemia. The patient denied any symptoms related to hypercalcemia. Laboratory testing revealed calcium 2.77 mmol/l (Ref. 2.09–2.42), phosphate 0.64 mmol/l (Ref. 0.87–1.45), parathormone (PTH) 121.5 pg/ml (Ref. 15–65), creatinine 0.78 mg/dl (Ref. 0.5–0.9) and vitamin D 72 nmol/l. The patient had no evidence of renal lithiasis on renal ultrasound. Bone densitometry was normal. Although cervical ultrasound was normal, sestamibi scan revealed a left retrosternal lesion, suggestive of a parathyroid adenoma. A CT scan of the neck confirmed a suprasternal oval expansive lesion, in the anterior and superior mediastinum, with 21×11 mm, suggestive of an ectopic parathyroid adenoma. The patient denied family history of hypercalcemia. She is waiting for parathyroid surgery.

Conclusion: Most patients with primary hyperparathyroidism are asymptomatic, but others may present with symptoms related to chronic hypercalcemia, such as hypertension. Hypertension may or may not remit after successful parathyroidectomy. We will follow this patient to evaluate hypertension remission.