Can Diabetes Associated With Hyperparathyroidism Be an Additional Indication for Parathyroidectomy? A Case Report

P Reddy; C Harinarayan; V Suresh; A Jena; M Reddy; T Kalawat; M Moorthy; S Vittal; A Sachan

International Journal of Endocrinology and Metabolism

Research Institute for Endocrine Sciences

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Can Diabetes Associated With Hyperparathyroidism Be an Additional Indication for Parathyroidectomy? A Case Report

Author(s):

P A Reddy¹,

C V Harinarayan¹,

V Suresh¹,

A Jena¹,

M K Reddy¹,

T C Kalawat¹,

M S Moorthy¹,

S Vittal²,

A Sachan^3,*

1Department of Endocrinology and Metabolism, Sri Venkateswara Institute of Medical Sciences, Andhra Pradesh, India

2Department of Surgery, Sree Sai Krishna Hospital, Tamil Nadu, India

3Department of Endocrinology and Metabolism, Sri Venkateswara Institute of Medical Sciences, alok_sachan@rediffmail.com, Andhra Pradesh, India

International Journal of Endocrinology and Metabolism:Vol. 7, issue 3; 208-211

Article type:Case Report

Received:Jul 24, 2009

Accepted:Aug 20, 2009

How to Cite:P A ReddyC V HarinarayanV SureshA JenaM K ReddyT C KalawatM S MoorthyS VittalA Sachanet al.Can Diabetes Associated With Hyperparathyroidism Be an Additional Indication for Parathyroidectomy? A Case Report.Int J Endocrinol Metab.7(3):208-211.

Abstract

Primary hyperparathyroidism is not uncommon. It has varied presentations ranging from asymp-tomatic disease to the classic “stones, groans, moans”. This is a case report of a 49 year-old woman, who presented with sensory obtunda-tion, abdominal pain, associated with vomiting and denovo detected diabetes mellitus. She had a past history of bilateral nephrolithiasis, and was found to have hypercalcemia (serum corrected calcium 12.8 mg/dL) with elevated serum intact parathormone (183 pg/mL, normal range 13-54 pg/mL). The 99m-Tc MIBI scintigraphy localized the source of parathormone to the right inferior parathyroid gland. Being dehydrated, she was treated with saline diuresis, salmon calcitonin and intravenous pamidronate. Her blood sugar was reported to be 421 mg/dL, and the glycemia was controlled with insulin therapy. A 2 X 2 cm sized right inferior parathyroid adenoma was later removed. The glycemic status improved dramatically after parathyroidectomy and the patient was euglycemic on low doses of glimepiride. This case study suggests that pri-mary hyperparathyroidism might also contribute to hyperglycemia in subjects with diabetes mel-litus.

Keywords

Primary hyperparathyroidism

Coma

Diabetes mellitus

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