Approach and diagnosis primary hyperparathyroidism with recurrent urolithiasis
1Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
Calcium, one of the common elements in our body, plays an important role in physiological functions. Mild hypercalcemia will develop vague neuropsychiatric symptoms, peptic ulcer disease, urolithiasis, and increased fracture risk. Severe hypercalcemia can cause symptoms like nausea, anorexia, constipation, pancreatitis, lethargy, stupor or coma. If we couldn’t correct its level and treat underlying diseases in time, it may progress into chronic kidney disease, nephrocalcinosis and even renal failure or bone fracture. However, measurement of blood calcium is always not a routine order compared to sodium and potassium in our medical practice. Furthermore, sometimes we treat urinary tract stone or bone fracture simply without surveying patient’s blood calcium level to rule out the potential causes of hypercalcemia and thus delay the precise diagnosis and management.
Here, we describe a case of a 63-year-old man presenting with chronic kidney disease and recurrent urolithiasis for many years diagnosis with high PTH level due to the primary hyperparathyroidism. With an early diagnosis and appropriate treatment provide a good prognosis in most of hypercalcemia. The purpose of this case report is to help us get diagnosis earlier, do a complete approach of hypercalcemia to avoid serious complications and remind us the pitfall in hypercalcemia.