A case of concomitant hyperthyroidism and hyperparathyroidism due to parathyroid hyperplasia / 대한내과학회지

ABSTRACT

Concurrent hyperthyroidism and primary hyperparathyroidism in the same patient is rare. In most cases of concomitant hyperthyroidism and primary hyperparathyroidism, serum calcium levels are quite elevated. However, recently we diagnosed a patient who had hyperthyroidism [Triiodothyroxine 6.81 nmol/L (1.23-3.39), Free thyroxine 92.88 pmol/L (10.32-25.80), TSH 0.05 mU/L (0.2-7.0)] and primary hyperparathyroidism [parathyroid hormone 163 pg/mL (12-72)] with mild hypercalcemia 2.78 mmol/L (2.03-2.60)]. We treated this patient with propylthiouracil and pamidronate and normalized her thyroid function and serum calcium levels. We then performed subtotal thyroidectomy and removed two parathyroid glands and clipped one parathyroid gland using a hemoclip. The pathologic diagnosis was confirmed to be Graves' disease and parathyroid hyperplasia. The patient was healthy, and serum levels of PTH, calcium and phosphorus were normal after the operation.