Can Diabetes Associated With Hyperparathyroidism Be an Additional Indication for Parathyroidectomy?A Case Report

Primary hyperparathyroidism is not un-common. it has varied presentations ranging from asymptomatic disease to the classic “stones, groans, moans”. this is a case report of a 49 year-old woman, who presented with sensory obtunda- tion, abdominal pain, associated with vomiting and denovo detected diabetes mellitus. she had a past history of bilateral nephrolithiasis, and was found to have hypercalcemia (serum cor-rected calcium 12.8 mg/dl) with elevated serum intact parathormone (183 pg/ml, normal range 13-54 pg/ml). the 99m-tc mibi scintigraphy lo-calized the source of parathormone to the right inferior parathyroid gland. being dehydrated, she was treated with saline diuresis, salmon cal- citonin and intravenous pamidronate. her blood sugar was reported to be 421 mg/dl, and the gly- cemia was controlled with insulin therapy. a 2 x 2 cm sized right inferior parathyroid adenoma was later removed. the glycemic status im- proved dramatically after parathyroidectomy and the patient was euglycemic on low doses of glimepiride. this case study suggests that pri- mary hyperparathyroidism might also contribute to hyperglycemia in subjects with diabetes mel-litus.