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Forum Name: Endocrinology Topics

Question: failure to diagnose hyperparathyroidism and complications


 fayme - Tue Jan 13, 2009 9:25 am

Hi

My sisters and I are all convinved my mother has hyperparathyroidism that has gone undetected and is now leading to complications (osteoporosis, kidney stones, congestive heart failure - she was hospitalised on boxing day as being nearly in a coma).
My mother thinks it is congestive heart failure and neither she nor her doctors have so far looked into hyperparathyroidism as the routine blood tests came back within normal range. However I understand that some 7-12% of HPT cases never show significantly elevated blood calcium or HPT rates but that these are therefore difficult to diagnose.
Are we right in saying the CHF she now suffers is likely to be result of untreated HPT given these symptoms and how can we make people investigate HPT?
fayme
 John Kenyon, CNA - Wed Feb 25, 2009 10:23 pm

User avatar Hello Fayme --

This is a difficult question you pose, because hypoparathyroidism is a real problem in older patients (although based on your age I'd be surprised if your mother is in the range where this is usually seen). Hypoparathyroidism is a big problem in the geriatric range largely because it is often difficult to diagnose, but sometimes the team needs to apply reason and observe cause-and-effect even when the laboratory doesn't necessarily support the suspicion. The components are mostly there, including CHF, which eventually tends to show up in these cases anyway. I would very much like to see if your mother's doctors would be willing to take a look at her cervical spine for signs of degeneration there, because this is often seen with hypoparathydoidism (due to osteoporosis) and can cause some of the more severe symptoms later on. It won't prove that's what's going on, but it would certainly add to the preponderance of evidence.

That being said, there's no real way to support your conclusion that CHF is being caused by hypoparathyroidism, since there is no clinical evidence for it, and CHF is also common on its own in geriatric patients. Also, there's no good way to "make" doctors follow your instincts, even if those instincts happen to seem pretty on target. This is one of those areas of medicine which remains cloudy because the doctor is, after all, the doctor, and isn't going to readily allow himself to be directed by the patient, although some will certainly be more open to suggestions than others. You can hope this may be the case, but you can't "make" anyone look where you'd like them to look. There is always, of course, the option of second opinions, consults, etc.

I hope this is helfpful to you, and just for the record, I'd personally pursue the possibility via whatever route presents itself, to rule out (or in) hypoparathyroidism. Good luck to you with this. Please follow up with us as needed.
 sara2806 - Sun May 10, 2009 10:33 am

Hi , my aunt has Hyperparathyroidism , she also has hypocalcemia for around 20 years. She has had the affected gland removed and is taking medication such as Vitamin D and Calcium. But this till does no make her feel better, her calcium levels keep dropping and rising and for the past years it has never became stable. We need help and advice on what can she do to treat or cure this condition, we also think she might have developed sometime else. These are the symptoms:
- Pain and cramps in the leg
-high and low calcium levels
-vomiting
-fainting
-pain and cramps in face
-kidney stones
Please can you tell me if these are the normal symptoms of hyperparathyroidism and hypocalcemia. Or has she developed sometime else.
Write back as soon as possible
Thanks
Sara

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