Document Detail


Primary hyperparathyroidism presenting with severe hypertension in a middle aged Nigerian--a case report.
MedLine Citation:
PMID:  18408787     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To draw attention to primary hyperparathyroidism as a cause of severe hypertension. RESULTS: A 47 year old Nigerian male presented with headache, occasional blurring of vision and dyspnoea on mild exertion of 2/12 duration. He had been troubled by painful osteoarthritis of the knees for 2 years for which he was taking NSAIDs. He was found to be severely hypertensive, BP 210/130mmHg and had bilateral knee crepitus. BP was resistant to control on Nifedipine R and Moduretic. Serum urea, creatinine, uric acid were normal but there was hyperacalcaemia and hyperchloraemia. Haematological indices, urinalysis, microscopy and culture of urine were normal. Parathyroid hormone level was raised. A parathyroid MIBI scan study showed an extensive area of significance towards the inferior pole of the right lobe of thyroid medially with a second area of very low significance medial to the left pole. These findings indicated the presence of a right inferior parathyroid adenoma. He had parathyroid surgery and a large adenoma in the right inferior gland and a smaller left inferior gland were removed and confirmed histologically. Corrected calcium and parathyroid hormone levels dropped to normal, and the BP was easily controlled with Lisinopril 5mg daily subsequently. He is not currently on antihypertensive medication two years post surgery. CONCLUSION: This case highlights the need for thorough investigation of cases of hypertension to exclude specifically secondary causes, which in some cases may be endocrine in origin and may easily be corrected.
Authors:
F H Puepet; E I Agaba; E K Chuhwak; S O Ugoya
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Nigerian postgraduate medical journal     Volume:  15     ISSN:  1117-1936     ISO Abbreviation:  Niger Postgrad Med J     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-04-14     Completed Date:  2008-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9613595     Medline TA:  Niger Postgrad Med J     Country:  Nigeria    
Other Details:
Languages:  eng     Pagination:  58-60     Citation Subset:  IM    
Affiliation:
Endocrine and Metabolic Unit, Department of Medicine Jos University Teaching Hospital Jos P.M.B 2076 Jos, Plateau State, Nigeria. puepetfh@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
Adenoma / diagnosis,  surgery
Antihypertensive Agents / therapeutic use
Humans
Hyperparathyroidism, Primary / diagnosis*,  etiology*
Hypertension / complications*,  drug therapy
Lisinopril / therapeutic use
Male
Middle Aged
Nigeria
Osteoarthritis, Knee / complications
Parathyroid Neoplasms / diagnosis,  surgery
Parathyroidectomy
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 83915-83-7/Lisinopril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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