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High blood pressure as the first manifestation and multiple organ dysfunction in primary hyperparathyroidism: a case report

Hypertension Research volume 43, pages 1125–1127 (2020)Cite this article

Primary hyperparathyroidism (PHPT) is an endocrine disease of the parathyroid in which the parathyroid synthesizes and secretes an excess of parathyroid hormone (PTH). It can cause disorders of calcium and phosphorus metabolism. The disease has no specific clinical manifestation. Although its discovery can be prompted by laboratory indicators of hypercalcemia and hypophosphatemia, these results are often affected by many factors and are usually normal at the early stage of the disease [1]. These factors increase the difficulty of diagnosis, which may lead to the long course of disease and multiple organ dysfunction. PHPT with elevated blood pressure as the first manifestation is rare. Here, we report a case of PHPT with high blood pressure as the first manifestation accompanied by multiple organ dysfunctions.

The patient is a 50-year-old woman. She underwent a thyroid ultrasound in 2016, and no abnormality was found. She had hypertension in February 2018, with the highest self-measured blood pressure reaching 165/95 mmHg. She took felodipine, and her blood pressure was well controlled. On April 10th, she presented with dizziness, nausea and intermittent vomiting, and her blood pressure was 173/87 mmHg. Then, she took felodipine, valsartan, and rabeprazole. Her blood pressure decreased and dizziness symptoms were relieved, but nausea and intermittent vomiting remained, accompanied by abdominal distension and poor appetite. Then, she underwent gastroscopy, which showed gastroduodenitis. She was treated with rabeprazole, trimebutine maleate, and aluminum sulfate gel.

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References

  1. Cusano NE, Silverberg SJ, Bilezikian JP. Normocalcemic primary hyperparathyroidism. J Clin Densitom. 2013;16:33–9.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Pawlowska M, Cusano NE. An overview of normocalcemic primary hyperparathyroidism. Curr Opin Endocrinol Diabetes Obes. 2015;22:413–21.

    Article  CAS  PubMed  Google Scholar 

  3. Lundgren E, Rastad J, Thrufjell E, Akerstrom G, Ljunghall S. Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery. 1997;121:287–94.

    Article  CAS  PubMed  Google Scholar 

  4. Maruani G, Hertig A, Paillard M, Houillier P. Normocalcemic primary hyperparathyroidism: evidence for a generalized target-tissue resistance to parathyroid hormone. J Clin Endocrinol Metab. 2003;88:4641–8.

    Article  CAS  PubMed  Google Scholar 

  5. Yao XA, Wei BJ, Jiang T, Chang H. The characteristics of clinical changes in primary hyperparathyroidism in Chinese patients. J Bone Min Metab. 2019;37:336–41.

    Article  CAS  Google Scholar 

  6. Broulik PD, Broulikova A, Adamek S, Libansky P, Tvrdon J, Broulikova K, et al. Improvement of hypertension after parathyroidectomy of patients suffering from primary hyperparathyroidism. Int J Endocrinol. 2011;2011:309068.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Tianjin First Center Hospital, No. 24, Fukang Road, Nankai District, Tianjin, 300192, China

    Yongle Jing, Chengzhi Lu, Dasheng Xia & Wei Xia

  2. Department of Anesthesiology, Tianjin First Center Hospital, No. 24, Fukang Road, Nankai District, Tianjin, 300192, China

    Yuli Wu

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  1. Yongle Jing
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  2. Chengzhi Lu
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Correspondence to Yuli Wu.

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Jing, Y., Lu, C., Xia, D. et al. High blood pressure as the first manifestation and multiple organ dysfunction in primary hyperparathyroidism: a case report. Hypertens Res 43, 1125–1127 (2020). https://doi.org/10.1038/s41440-020-0447-8

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