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  • Hyperplastic thyroid nodule masquerading as parathyroid adenoma in a patient with tubercular lymphadenitis induced hypercalcaemia

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Unusual presentation of more common disease/injury
Case report
Hyperplastic thyroid nodule masquerading as parathyroid adenoma in a patient with tubercular lymphadenitis induced hypercalcaemia
  1. Alpesh Goyal1,
  2. Shipra Agarwal2,
  3. Ravinder Goswami1 and
  4. Chandrasekhar Bal3
  1. 1Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Department of Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  3. 3Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Shipra Agarwal; drshipra0902{at}gmail.com

Abstract

Serum intact parathyroid hormone (iPTH) levels are high or high normal in patients with parathyroid adenoma. Rarely these patients can have normal or low serum iPTH values. With sandwich immunometric assays, an exceptionally high serum iPTH level can lead to falsely low measurement due to the ‘hook effect’. Here, we describe the case of a 66-year-old female patient with PTH-independent hypercalcaemia which mimicked parathyroid adenoma. A multidisciplinary team approach helped in the diagnosis and management leading to complete recovery.

  • pathology
  • calcium and bone

https://doi.org/10.1136/bcr-2020-237261

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    Footnotes

    • Contributors AG, SA and RG diagnosed and managed the patient. AG and SA reviewed the literature and prepared the initial draft of the manuscript which was edited by CB and RG. All authors read and approved the final version of the manuscript. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.