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Diagnosis and Treatment > Medication

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Cheuk-Lik Wong Department of Medicine and Geriatrics, Caritas Medical Centre, Shamshuipo, Kowloon, Hong Kong SAR

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Chun-Kit Fok Department of Medicine and Geriatrics, Caritas Medical Centre, Shamshuipo, Kowloon, Hong Kong SAR

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Vicki Ho-Kee Tam Department of Medicine and Geriatrics, Caritas Medical Centre, Shamshuipo, Kowloon, Hong Kong SAR

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Summary

We report a case of elderly Chinese lady with neurofibromatosis type-1 presenting with longstanding palpitation, paroxysmal hypertension and osteoporosis. Biochemical testing showed mild hypercalcaemia with non-suppressed parathyroid hormone level suggestive of primary hyperparathyroidism, and mildly elevated urinary fractionated normetanephrine and plasma-free normetanephrine pointing to a catecholamine-secreting pheochromocytoma/paraganglioma. Further scintigraphic investigation revealed evidence of a solitary parathyroid adenoma causing primary hyperparathyroidism and a left pheochromocytoma. Resection of the parathyroid adenoma and pheochromocytoma resulted in normalization of biochemical abnormalities and hypertension. The rare concurrence of primary hyperparathyroidism and pheochromocytoma in neurofibromatosis type-1 is discussed.

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Taxonomy:
Clinical Overview, Gland/Organ, Adrenal, Topic, Bone, Hormone, Metanephrines, Noradrenaline, Normetanephrine, PTH, Condition/ Syndrome, Hypercalcaemia, Hyperparathyroidism (primary), Neurofibromatosis, Parathyroid adenoma, Phaeochromocytoma, Patient Demographics, Age, Adult, Gender, Female, Ethnicity, Asian - Chinese, Country of Treatment, Hong Kong, Diagnosis and Treatment, Signs and Symptoms, Hypercalcaemia, Hypertension, Neurofibromas, Osteoporosis, Palpitations, Investigation, Blood pressure, Calcium (serum), CT scan, Metanephrines (plasma), Metanephrines (urinary), MIBG scan, Norepinephrine, Normetanephrine, PTH, Sestamibi scan, Ultrasound scan, Intervention, Adrenalectomy, Parathyroidectomy, Resection of tumour, Medication, Alpha-blockers, Beta-blockers, Propranolol, Terazosin, Related Disciplines, Dermatology, Publication Details, Case Report Type, Unique/unexpected symptoms or presentations of a disease
DOI:
https://doi.org/10.1530/EDM-18-0006
Volume/Issue:
Volume 2018: Issue 1
Open access