Severe renal and skeletal presentation of primary hyperparathyroidism in a young adult: a report of two cases

Abstract

Primary hyperparathyroidism is a rare endocrine disease characterized by excessive secretion of parathyroid hormone, which generally produces hypercalcemia and a range of variable clinical manifestations. A study was conducted to describe the severe renal and skeletal manifestations of primary hyperparathyroidism found in two cases of young adults seen in the Endocrinology Department of the Hospital Clínico Quirúrgico “Hermanos Ameijeiras”, Havana, Cuba. The first case: a 22-year-old female patient with generalized osteoporosis, a salt-and-pepper lytic pattern in the frontoparietal region of the skull, subperiosteal resorption at the distal ends of the tibias and phalanges, brown tumors at the level of the right scapula and left glenoid and metacarpals, and a pathological fracture of the right femur. The second: a 22-year-old male patient with a deformity at the right hip, a shortened and externally rotated right lower limb, with functional inability to stand and walk, and multiple brown tumors in the bony pelvis. In both cases, surgical treatment was performed, and a pathological diagnosis of parathyroid adenoma was confirmed, with favorable outcomes. Severe renal and skeletal presentations of primary hyperparathyroidism are rare in young adults. Timely diagnosis and treatment improve the quality of life of those affected and prevent potentially fatal complications.