HYPERPARATHYROIDISM AND UROLITHIASIS: DIAGNOSTICS ERRORS (clinical case)
Aim. To invite attention of professionals to hyperparathyroidism in order to assure its early diagnostics in patients with bone and nephrological masks of the disease. Material and methods. The incidence of primary hyperparathyroidism among patients with urolithiasis is 8%. Visceral form with predominant renal damage occurs in over 60% of cases of primary hyperparathyroidism manifest. Kidney damage may be the only manifestation of primary hyperparathyroidism. Often it occurs in the form of urolithiasis. The surgical intervention in primary hyperparathyroidism is not a method of urolithiasis treatment, but just a way to get rid of the patient concretions. Results and discussion. The case is a patient with recurrent kidney stones, over which the surgery was performed twice. Unfortunately, the removal of calculus does not cure the patient if the cause of the changes that led to the development of urolithiasis is not known. Besides complaints of the patient and the clinical manifestations of hyperparathyroidism screening test for blood calcium level was not carried out on time, which has led to the renal damage with the development of urolithiasis and osteoporosis with pathologic fractures. Adenoma of the parathyroid gland and primary hyperparathyroidism were detected during occasional visit to endocrinologist followed by successful parathyroidectomy. Conclusion. The clinical case demonstrates errors and late diagnostics of primary hyperparathyroidism, which is related to poor knowledge of the manifestations of hyperparathyroidism, its bone and nephrology masks as well as the necessity to introduce the serum calcium level measurement in routine biochemical practice.