Parathyroid adenoma presenting as tetraparesia.

OBJECTIVE: Parathyroid adenomas (PA) are benign tumors. We report an unusual case of delayed diagnosis of a PA and concomitant Vitamin D deficiency presenting as tetraparesia.

METHODS: A 30-year-woman was admitted to our clinic with an inability to walk. Our examination revealed tetraparesia and common, severe muscular atrophy.

RESULTS: Laboratory investigations showed the following: creatinine phosphokinase (CK): 37 IU/L (15-130), calcium (Ca): 11.5 mg/dL (9-11), phosphorus (P): 1.5 mg/dL (2.5-5), parathyroid hormone (PTH): 736.1 pq/mL (15-65), 25-hydroxyvitamin D (25-OHvit D): 4 ng/mL (11-43), and alkaline phosphatase (ALP): 1029.5 lU (64-300). Parathyroid scintigraphy revealed PA. A year after Vitamin D replacement, the patient's neurological status and laboratory findings improved.

CONCLUSION: We suggest that the physicians always keep in mind the primary hyperparathyroidism (HPT) and concomitant Vitamin D deficiency in the differential diagnosis of hypercalcemia when facing atypical neurological symptoms such as tetraparesia.

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