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Descended right superior parathyroid adenoma mimicking as inferior adenoma in primary hyperparathyroidism
  1. Kripa Elizabeth Cherian1,
  2. Deepak Thomas Abraham2,
  3. Thomas Vizhalil Paul3,
  4. Nihal Thomas1
  1. 1Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
  2. 2Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, India
  3. 3Endocrinology Department, Christian Medical College, Vellore, Tamil Nadu, India
  1. Correspondence to Professor Thomas Vizhalil Paul, thomasvpaul{at}

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A 22-year-old woman presented with generalised bony pains over past 2 years. Clinical examination was unremarkable, and blood biochemistry revealed parathyroid hormone (PTH)-dependent hypercalcaemia, suggestive of primary hyperparathyroidism (albumin-corrected calcium −11 mg/dL (normal range 8.3–10.4); PTH −256 pg/mL (normal range 8–50)). Her creatinine was 0.8 mg/dL (normal range 0.6–1.2) and 25-OH vitamin D level was 31 ng/mL (30–75). She had low bone mass at distal end of radius (Z score of −2.8) and there was no evidence of renal stones. On localisation, both parathyroid scinitigraphy and ultrasound of neck localised the lesion to right inferior gland (figure 1A,B). There were no features of multiple endocrine …

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