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| A case report and literature review of primary hyperparathyroidism with renal calculi as the first symptom |
| HE Yongmao1 SHAO Minghai1 LAN Tianying2 WANG Chen3 YE Chaoyang4 |
1.Department of Nephrology, Shuguang Hospiatl Affiliated to Shanghai University of Traditional Chinese Medicine, Shanhai 201203, China;
2.Institute of Traditional Chinese Medicine Nephropathy, Shanghai University of Traditional Chinese Medicine, Shanhai 201203, China;
3.Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanhai 201203, China;
4.Key Laboratory of Liver and Kidney Diseases（Shanghai University of Traditional Chinese Medicine）, Ministry of Education, Shanghai 201203, China |
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Abstract
[Abstract] This paper reports a case of primary hyperparathyroidism (PHPT) with kidney calculi as the main symptom. This patient had a history of dry mouth polydipsia and polyuria for more than 20 years, which was not properly diagnosed and treated. In this case, the main symptoms of renal stone obstruction were low back pain, abdominal distension, nausea and vomiting, gross hematuria, etc. After lefe parathyroidectomy, PHPT was clearly diagnosed by pathology. After laser lithotripsy, drug therapy, and parathyroid adenoma resection, blood calcium, urine and renal function were recovered, small calculi were left in both kidneys, and parathyroid hormone (PTH) was still elevated after operation, and returned to normal two months after operation. Renal and parathyroid imaging, renal function, serum calcium, PTH, and urinary calcium levels were followed up. The diagnosis of PHPT includes qualitative and locational diagnosis, laboratory examination makes qualitative diagnosis, and imaging examination is used for localization and quantification. In terms of treatment, medical treatment can alleviate the hypercalcemia emergency, and surgical treatment is the first choice for the complete cure of PHPT, the surgical method was selected according to the location and number of lesions, intraoperative PTH monitoring is beneficial to improve the cure rate, if PTH and serum calcium are still elevated during postoperative follow-up, secondary hyperparathyroidism should be considered first, and the possibility of incomplete surgery or recurrence should be excluded.
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