Campos-Márquez GP, Téllez-Arce G, Rodríguez-Rivera JA, García-González EA, Cabeza-Bucio E, Farias-Cortés JD

Language: Spanish
References: 10
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ABSTRACT

Description of the clinical case: A 62-year-old female comes to our unit with oppressive pain in the bilateral lumbar area. Bilateral ureteral lithiasis was diagnosed those conditions severe bilateral hydronephrosis and it was decided to divert the urinary tract to later perform a definitive treatment. Due to the findings in the laboratory and cabinet studies, primary hyperparathyroidism was diagnosed as the cause of the bilateral ureteral lithiasis.
Relevance: The presence of stones indicates the need for parathyroidectomy in patients diagnosed with primary hyperparathyroidism with hypercalcemia or normocalcemia unless there are contraindications. Patients with nephrolithiasis should explore strategies to prevent stone formation even after parathyroidectomy.
Clinical implications: The most common consequences of excessive parathyroid hormone secretion are hypercalciuria and kidney stones. They occur in 8-20% of patients with primary hyperparathyroidism and are the most common complication of the disease. They can be silent in 7-11% and bilateral in 16.4% of patients. It is very important to be able to identify patients with this disease to avoid multiple complications.
Conclusions: Patients with primary hyperparathyroidism have a high risk of developing kidney complications. We must analyze all the factors that made us suspect in a primary hyperparathyroidism in patients who debut with renal or ureteral stones and thus avoid the recurrence of the same.

REFERENCES

1. Lemos ALP, Andrade SR de L, Pontes LLH,Teixeira PMC, Bandeira E, Bandeira LC,et al. High Rate of Occult Urolithiasis inNormocalcemic Primary Hyperparathyroidism.Kidney Blood Press Res. 2019;44(5):1189–95.doi: https://doi.org/10.1159/000502578

2. Misgar RA, Sehgal A, Masoodi SR, Wani AI,Bashir MI, Malik AA, et al. A Comparisonbetween Silent and Symptomatic Renal Stonesin Primary Hyperparathyroidism. Indian JEndocrinol Metab. 2019;23(1):46–9. doi:https://doi.org/10.4103/ijem.IJEM_558_18

3. Naples R, Shin JJ, Berber E, Jin J,Krishnamurthy VD, Siperstein AE. Recognitionof primary hyperparathyroidism: Delayedtime course from hypercalcemia to surgery.Surgery. 2020;167(2):358–64. doi: https://doi.org/10.1016/j.surg.2019.07.031

4. Reid LJ, Muthukrishnan B, Patel D, SecklJR, Gibb FW. Predictors of Nephrolithiasis,Osteoporosis, and Mortality in PrimaryHyperparathyroidism. The Journal ofClinical Endocrinology & Metabolism.2019;104(9):3692–700. doi: https://doi.org/10.1210/jc.2018-02483

5. Perez AA, Schneider DF, Long KL, Pitt SC,Sippel RS. Timely Evaluation and Managementof Primary Hyperparathyroidism in PatientsWith Kidney Stones. Journal of SurgicalResearch. 2018;232:564–9. doi: https://doi.org/10.1016/j.jss.2018.07.028

6. Minisola S, Gianotti L, Bhadada S, SilverbergSJ. Classical complications of primaryhyperparathyroidism. Best Pract Res ClinEndocrinol Metab. 2018;32(6):791–803. doi:https://doi.org/10.1016/j.beem.2018.09.001

7. Sanapureddy P, Garla VV, Pabbidi MR.Primary hyperparathyroidism: Labs to order, Txto consider. J Fam Pract. 2018;67(11):E16–21.

8. Cong X, Shen L, Gu X. Current opinionson nephrolithiasis associated with primaryhyperparathyroidism. Urolithiasis.2018;46(5):453–7. doi: https://doi.org/10.1007/s00240-018-1038-x

9. Machado NN, Wilhelm SM. Diagnosis andEvaluation of Primary Hyperparathyroidism.Surgical Clinics of North America.2019;99(4):649–66. doi: https://doi.org/10.1016/j.suc.2019.04.006

10. Valle Díaz de la Guardia F, Arrabal MartínM, Arrabal Polo MÁ, Quirosa Flores S, MijánOrtiz JL, Zuluaga Gómez A. Litiasis renal enpacientes con hiperparatiroidismo primario:Evolución y tratamiento. Archivos Españoles deUrología (Ed impresa). 2010;63(1):32–40.