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Anales de Otorrinolaringología Mexicana

2021, Número 3

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Otorrinolaringología 2021; 66 (3)


Hiperparatiroidismo primario debido a una glándula paratiroidea gigante

Moreno-Galeana S, Guerrero-Espinosa D

Idioma: Español
Referencias bibliográficas: 36
Paginas: 245-252
Archivo PDF: 217.41 Kb.


RESUMEN

Antecedentes: El hiperparatiroidismo primario se diagnostica por hipercalcemia y valores elevados de hormona paratiroidea. La causa de éste es principalmente por un adenoma paratiroideo en el 80% de los casos. El diagnóstico diferencial incluye la hipercalcemia hipocalciúrica familiar y los hiperparatiroidismos secundario y terciario. Muchos casos cursan asintomáticos, mientras que otros cursan con enfermedad ósea, renal, cardiovascular, neuropsiquiátrica y gastrointestinal.
Caso clínico: Paciente femenina de 55 años de edad quien inició su padecimiento hacía aproximadamente 20 años con infecciones de vías urinarias de repetición. Fue diagnosticada con litiasis renoureteral bilateral que ameritó en 2018 ureterolitotricia extracorpórea con colocación de catéter JJ bilateral, sin otros síntomas asociados se sospechó hipercalcemia debida a hiperparatiroidismo primario.
Conclusiones: El diagnóstico de hiperparatiroidismo primario se establece con exámenes bioquímicos sanguíneos y urinarios. Los estudios de imagen ayudan principalmente a valorar complicaciones óseas y renales y a la planeación quirúrgica. La biopsia preoperatoria no se recomienda. El único tratamiento curativo es la paratiroidectomía. Los avances quirúrgicos proporcionan abordajes mínimamente invasivos. El tratamiento médico no es curativo, pero es una alternativa a la cirugía.


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