Fernandes Carolina, Vieira Vera, Diogo Cláudia, Domingues Ana Catarina, Rodrigues Ana
Internal Medicine Department, Unidade Local de Saúde da Região de Leiria, Leiria, PRT.
Intensive Care Unit, Unidade Local de Saúde da Região de Leiria, Leiria, PRT.
Cureus. 2024 Sep 25;16(9):e70179. doi: 10.7759/cureus.70179. eCollection 2024 Sep.
Tertiary hyperparathyroidism is characterized by increased parathyroid hormone (PTH) secretion that appears after prolonged secondary hyperparathyroidism, leading to the onset of hypercalcemia. The parathyroid glands are found to undergo hyperplastic or adenomatous changes and act autonomously with increased parathormone secretion not suppressed by feedback control. This entity is commonly associated with long-term secondary hyperparathyroidism states, such as chronic kidney disease, renal transplantation, and gastrointestinal malabsorption. The authors describe the case of a 50-year-old female with a history of biliopancreatic diversion surgery, renal lithiasis with recurrent obstructive pyelonephritis, and a work accident with significant limitation of mobility. She was referred to hospital consultation for a pathological fracture of the dorsal vertebra in the context of tertiary hyperparathyroidism due to long-term gastrointestinal malabsorption.
三发性甲状旁腺功能亢进的特征是在长期继发性甲状旁腺功能亢进后出现甲状旁腺激素(PTH)分泌增加,导致高钙血症的发生。发现甲状旁腺发生增生或腺瘤样改变,并自主发挥作用,甲状旁腺激素分泌增加,不受反馈控制的抑制。这种情况通常与长期继发性甲状旁腺功能亢进状态有关,如慢性肾脏病、肾移植和胃肠道吸收不良。作者描述了一名50岁女性的病例,该女性有胆胰分流术病史、复发性梗阻性肾盂肾炎伴肾结石病史,以及因工作事故导致行动严重受限。由于长期胃肠道吸收不良,她因三发性甲状旁腺功能亢进导致胸椎病理性骨折而被转诊至医院会诊。