DOI: 10.12688/f1000research.192069.1 ISSN: 2046-1402

Case Report: Primary hyperparathyroidism with intrathyroidal adenoma in a patient with systemic lupus erythematosus and antiphospholipid syndrome: The first case report

Wafa Baya, Teheni Dardouri, Syrine Moussa, Safia Sakly, Imen Ben Hassine, Jihed Anoun, Fatma Ben Fredj Ismail
Show PDF Cite
The occurrence of primary hyperparathyroidism (PHP) in patients with systemic lupus erythematosus (SLE) is rare. The few cases reported parathyroid adenoma as the origin of PHP. We herein, report the first case of concomitant diagnosis of PHP with ectopic intrathyroidal adenoma and SLE associated with antiphospholipid syndrome (APS). A 43-years old woman presented with deep venous thrombosis (DVT) and pulmonary embolism (PE) medically treated. The etiological screening retained APS associated with SLE diagnosed. Other than that, biological tests revealed hypercalcemia, hypophosphatemia and elevated levels of parathyroid hormone (PTH) leading to the diagnosis of PHP. Cervical ultrasound and SPECT/CT parathyroid scintigraphy found a suspect thyroidal nodule with a pathological parathyroid gland. Thyroid lobectomy and isthmectomy histopathological examination revealed inferior intrathyroidal adenoma. Surgical intervention permitted to correct calcium-phosphate disturbances and to normalize PTH levels. Hypercalcemia in SLE patients should be roughly investigated. Even if PHP is a common cause of hypercalcemia in general population, it remains rare in SLE patients. In such cases, ectopic adenoma is exceptional.

More from our Archive