Celiac disease and primary hyperparathyroidism

OBJECTIVE

Primary hyperparathyroidism (PHPT) and celiac disease (CD) are two distinct medical conditions that can affect bone health. While PHPT leads to excessive calcium levels and bone abnormalities, CD impairs calcium and vitamin D absorption due to small intestine damage.

CASE REPORT

We present a case of a 49-year-old woman diagnosed with osteoporosis who was found to have both PHPT and CD. The patient underwent a successful minimally invasive parathyroidectomy, which resulted in decreased parathyroid hormone levels.

CONCLUSION

This case highlights the rare coexistence of PHPT and CD and emphasizes the importance of considering secondary causes of osteoporosis in patients with low bone mass. Further studies are needed to explore the underlying mechanisms and potential links between PHPT and CD.

25(OH)D levels during the COVID-19 pandemic: impact of lockdown and ultraviolet radiation

BACKGROUND

Home confinement policies during the COVID-19 pandemic limited sun exposure and may have influenced on vitamin D levels.

OBJECTIVE

To assess changes in 25(OH)D during the COVID-19 pandemic and the impact of Mandatory Preventive Social Isolation (MPSI) on UV radiation recommended dose modified by clouds for the synthesis of vitamin D (UVDVC).

MATERIAL AND METHODS

A retrospective study was carried out on 15,908 patients in whom the level of 25(OH)D was determined between January 2019 and December 2021 in a centralized laboratory in Rosario, Argentina.

RESULTS

Lower levels of 25(OH)D were documented in people younger than 40 years during 2020, as well as a variation during the pandemic period, with lower values in the first wave. Lower levels of 25(OH)D were recorded in the post-MPSI period in comparison with the MPSI period (p < 0.00001), in addition to a higher frequency of hypovitaminosis D (48.6% vs. 36.1%). These differences were not observed in the comparison of the same periods of 2019. UVDVC did not vary between 2019 and 2020.

CONCLUSIONS

The restrictions due to the COVID-19 pandemic led to a higher frequency of hypovitaminosis D and lower frequency of optimal values.

Hypercalcemic crisis as a presentation of primary hyperparathyroidism

Hyperparathyroidism-induced hypercalcemic crisis (HIHC) is an unusual state of marked progressive primary hyperparathyroidism (PHPT). Patients have severe hypercalcemia and may have severe symptoms such as kidney failure, acute pancreatitis, and mental changes. PHPT is due to the presence of a single gland adenoma/ disease in 80 to 85%; parathyroid carcinoma is reported in <1%. Among patients with adenoma, atypical parathyroid tumor can be found infrequently. Parathyroidectomy is the only curative approach for PHPT. In this report we present three cases of HIHC due to giant parathyroid adenomas (GPAs), one of them with histopathological characteristics of an atypical parathyroid tumor, with satisfactory evolution after parathyroidectomy.