Tabbikha Omar, Chamy Joanne, El Khoury Michael
General Surgery, Faculty of Medicine and Medical Sciences at University of Balamand, Beirut, LBN.
Vascular and Endovascular Surgery, Haykel Hospital/Lebanese University, Beirut, LBN.
Cureus. 2023 Aug 30;15(8):e44378. doi: 10.7759/cureus.44378. eCollection 2023 Aug.
Normocalcemic primary hyperparathyroidism (NHPT) is a newly defined variant of primary hyperparathyroidism (PHPT). It's defined by consistently normal total and ionised calcium levels with elevated parathyroid hormone in the absence of secondary causes of hyperparathyroidism in at least three consecutive times over a period of three to six months. Consensus whether the same criteria used to recommend surgery in PHPT should be used to recommend surgery in NHPT is still lacking. Even though PHPT is known to cause hypophosphatemia, serum phosphate is not relevant when diagnosing it or NHPT. No current guideline include any phosphate cutoff level to guide management or indicate surgery in PHPT or NHPT patients. Herein, we present a rare case of incidental NHPT presenting with symptomatic hypophosphatemia and managed surgically.
血钙正常的原发性甲状旁腺功能亢进症（NHPT）是原发性甲状旁腺功能亢进症（PHPT）的一种新定义变体。它的定义是在三到六个月的时间内，至少连续三次甲状旁腺激素升高而总钙和离子钙水平持续正常，且无继发性甲状旁腺功能亢进的原因。对于是否应使用与推荐PHPT手术相同的标准来推荐NHPT手术，目前仍缺乏共识。尽管已知PHPT会导致低磷血症，但在诊断PHPT或NHPT时，血清磷酸盐并不相关。目前没有指南包括任何磷酸盐临界值来指导PHPT或NHPT患者的管理或指示手术。在此，我们报告一例罕见的偶然发现的NHPT病例，该病例表现为有症状的低磷血症并接受了手术治疗。
