6940 Thrombotic Events in Primary Hyperparathyroidism: Association or Coincidence?

• DOI: 10.1210/jendso/bvae163.523
• Publication Date: 2024-10-05T20:59:29Z
• Authors: Irving Alexis Gua...; Zhanna Zavgorodneva; Yahya EL-Soufi; Abdullah Khan; Tooraj Zahedi; Fan Zhang
• Keywords: Primary (astronomy); Association (psychology)

Abstract Disclosure: I.A. Guatemala Funes: None. Z. Zavgorodneva: Y. EL-Soufi: A. Khan: T. Zahedi: F. Zhang: Introduction: The classical manifestations of primary hyperparathyroidism are nephrolithiasis, osteoporosis, and hypercalcemia-related symptoms, such as abdominal pain, constipation, polydipsia, polyuria. Parathyroid crisis is a rare life-threatening presentation characterized by calcium levels above 14-15 mg/dl marked symptoms hypercalcemia. Here, we describe case bilateral pulmonary embolism in patient with severe hypercalcemia secondary to parathyroid adenoma. Case Report 70-year-old female past medical history hyperparathyroidism, who presented profound fatigue, shortness breath, polyuria constipation. denied any trauma, immobilization, or long-distance travel. On physical exam was confused, dehydrated, nonhypoxic but increased work breathing. Initial labs showed 19.2 mg/dL, significant elevated PTH 1113.9 pg/mL from her baseline 380.8 pg/mL, normal 25 VitD, acute kidney injury creatinine 0.9 mg/dL 2.8 mg/dL. level 24-hour urine collection 323 mg/24 hours. CT chest angiogram revealed lower lobe embolism. extremity duplex negative for venous thrombosis. Thyroid ultrasound demonstrated suspected left adenoma 2.1 x 1.4 cm. Renal renal calculi. Following treatment intravenous fluids, Calcitonin, Denosumab, improved 10.1 patient’s underwent parathyroidectomy. decreased significantly after Pathology report confirmed Discussion association between arterial thrombosis has been rarely reported. Calcium participates directly the platelet activation, aggregation, coagulation cascade. However, true correlation not well understood. It believed that indirect factors vasoconstriction, dehydration, cytotoxic effects due direct over function coagulation, may act together induce Unfortunately, much evidence hypercoagulability based on reports our could be one more this exists. age, absence other risk hypercoagulability, simultaneous manifestation hypercalcemic crisis, PE make likely pathogenetic origin thrombus formation. Conclusion: Physicians should cautious hypercalcemia-induced thrombotic events caused dehydration calcium-triggered clotting system aggregation. Presentation: 6/3/2024