Endocrine Abstracts

Introduction: Superficial phlebitis is a clinical manifestation found in many pathologies, often unexplored or mistaken for simple venitis. It should be noted that it may be part of the thromboembolic complications of primary hyperparathyroidism, or an unusual mode of revelation. We describe 2 clinical situations which illustrate this symptom discovered in two different contexts

Observation 1: 60-year-old patient admitted for investigation of symptomatic primary hyperparathyroidism revealed in a context of microlithiasis complicated by acute pyelonephritis with associated osteoarticular repercussions. During her hospitalization, the patient presented with painful edema of the limb, and ultrasound revealed venitis with thrombosis of the cephalic vein of the forearm. She was put on anticoagulant therapy for one month.

Observation 2: 26-year-old patient admitted to the endocrinology department for management of hyperparathyroidism with the following biological criteria: PTH: 5 times normal Hypercalcemia 120 mg/ and hypophosphatemia and hypercalciuria 430 mg/24 h. This is an asymptomatic hyperparathyroidism with no complications, for which the phosphocalcic work-up was performed mainly when superficial venous thrombophlebitis of the ESV occurred.

Discussion and conclusion: Primary hyperparathyroidism is an increasingly frequent pathology, the diagnosis of which may be delayed by a clinical picture that may be suggestive of non-specific clinical signs. Thromboembolic manifestations have been reported as part of the complications of primary hyperparathyroidism, and can also constitute an unexpected mode of revelation, ranging from simple superficial phlebitis to deep vein thrombosis, with the risk of progression to pulmonary embolism, which can be life-threatening. A phosphocalcic assessment should be carried out in any patient presenting a clinical thomboembolic picture.