A15382 Primary Hyperparathyroidism in a Patient with Primary Aldosteronism

Abstract

Objectives: Primary aldosteronism is sometimes complicated with hyperparathyroidism, which can be classified into secondary hyperparathyroidism due to increased urinary calcium excretion. Low calcium intake has been reported to be a risk of primary hyperparathyroidism, however, it is unclear whether primary aldosteronism is causally related to the occurrence of primary hyperparathyroidism. Herein, we report an interesting case of primary aldosteronism complicated with primary hyperparathyroidism. Methods: This is a case report. Results: A 58-year-old woman, who had a history of parathyroidectomy for primary hyperparathyroidism due to parathyroid adenoma at the age of 43, was admitted for 20-years history of hypertension without remarkable family histories including hypertension. Her hypertension had been gradually worsening and was not improved by the parathyroidectomy. The laboratory findings were as follows: creatinine, 0.61 mg/dL; potassium, 4.0 mEq/L; corrected alcium, 8.9 mg/dL; plasma aldosterone concentration, 156 pg/mL; plasma renin activity, < 0.1 ng/mL/h; intact PTH, 73 pg/mL. Confirmatory tests and adrenal venous sampling revealed idiopathic hyperaldosteronism. Conclusion: We presented a case of primary aldosteronism, who experienced primary hyperparathyroidism. Her hyperaldosteronism might have contributed to the development of primary hyperparathyroidism through high urinary calcium excretion. We may need to carefully consider a possible complication of not only secondary but also primary hyperparathyroidism in patients with primary aldosteronism.