Pathological fractures in a patient with concomitant hyperparathyroidism and multiple myeloma: Case report
DOI:
https://doi.org/10.1016/S0120-8845(13)70016-6Keywords:
fractures, spontaneous, parathyroid hormone, multiple myeloma, hyperparathyroidism, primary, case report, evidence level: IVAbstract
Due to the limited amount of information related to the association of multiple myeloma, hyperparathyroidism and pathological fractures, a case report is presented on a patient who arrived in the emergency room presenting with a pathological fracture accompanied with laboratory tests suggesting multiple myeloma, associated with increase serum calcium levels. This particular scenario led the medical team to consider a special therapeutical approach with regards of the presence and association of these two entities along with the diagnosis of a pathological fracture in the same patient.
Downloads
References
Martínez G, Hawkins F. Concepto, etiología y epidemiología del hiperparatiroidismo primario. Endocrinol Nutr. 2009;56 (Suppl 1): 2-7. https://doi.org/10.1016/S1575-0922(09)70849-6
MacKenzie-Feder J, Sirrs S, Anderson D, Sharif F, Khan A. Primary hyperparathyroidism: an overview. Int J Endocrinol. 2011;2011:251410. https://doi.org/10.1155/2011/251410
Stewart A. Hypercalcemia associated with cancer. N Engl J Med. 2005;352:373-9. https://doi.org/10.1056/NEJMcp042806
López JE, Romero JM, Arias LF. Compromiso esquelético en el hiperparatiroidismo primario. Iatreia. 2006;19:377-86. https://doi.org/10.17533/udea.iatreia.4325
Siilin H, Lundgren E, Mallmin H, Mellst rom D, Ohlsson C, Karlsson M, et al. Prevalence of primary hyperparathyroidism and impact on bone mineral densit y in elderly men: Mr Os Sweden. World J Surg. 2011;35:1266-72. https://doi.org/10.1007/s00268-011-1062-2
Bandeira F, Griz LH, Bandeira C, Pinho J, Lucena CS, Alencar C, et al. Prevalence of cortical osteoporosis in mild and severe primary hyperparathyroidism and its relationship with bone markers and vitamin D status. J Clin Densitom. 2009;12:195-9. https://doi.org/10.1016/j.jocd.2008.11.005
Verlaan L, Van der Wal B, De Maat GJ, Walenkamp G, Nollen-Lopez L, Van Ooij A. Primary hyperparathyroidism and pathological fractures: a review. Acta Orthop Belg. 2007;73: 300-5.
Bostan B, Erdem M, Gunes T, Sen C, Koseoglu RD. Overlooked primary hyperparathyroidism presented with fractures: case report. Ulus Travma Acil Cerrahi Derg. 2010;16:567-70.
Gutiérrez MA, Rodríguez FA, Torres EM, Cruz H. Caso clínico patológico: hiperparatiroidismo primario. Rev Fac Med UNAM. 2001;44:33-5.
Scharschmidt T, Lindsey J, Becker P, Conrad E. Mult iple myeloma: diagnosis and orthopaedic implications. J Am Acad Orthop Surg. 2011;19:410-9. https://doi.org/10.5435/00124635-201107000-00004
Khandwala HM, Boctor MA. Multiple myeloma presenting with recurrent hypercalcemia in a patient with a history of primary hyperparathyroidism: report of case and review of literature. Endocr Pract. 2004;10:345-7. https://doi.org/10.4158/ep.10.4.345
Fanari Z, Kadikoy H, Haque W, Pacha O, Abdellat if A. Medical management of primary hyperparat hyroidism with concommitant multiple myeloma. Inter Med. 2010;49:581-4. https://doi.org/10.2169/internalmedicine.49.2705
Bogas M, Cost a L, Araúj o D. Hiperparat iroidismo primário coexistindo com myeloma múltiplo: associação e manifestações raras. Acta Rreumatol Port. 2008;33:98-105.
Pat el N, Talwar A, Donahue L, John V, Margoulef f D. Hyperparathyroidism accompanying multiple myeloma. Clin Nucl Med. 2005;30:540-2. https://doi.org/10.1097/01.rlu.0000170012.06271.76
Tsuj imura H, Nagamura F, Iseki T, Kanazawa S, Saisho H. SigniÞ cance of parathyroid hormone-related protein as a factor st imulat ing bone resorpt ion and causing hypercalcemia in myeloma. Am J Hematol. 1998;59:168-70. https://doi.org/dkdrt8
Hussain A, Mahmood H, Geddoa E, Hamish M, Reda AH. Parat hyroid adenoma and hypercalcemia in a pat ient presenting with multiple pathological fractures of the long bones. Int J Surg. 2008;6:465-8. https://doi.org/10.1016/j.ijsu.2006.05.018
Rosen C, Segal H, Hart z CE, Mroz F, Carlt on E. Primary hyperparat hyroidism in an elderly patient with mult iple myeloma. J Am Geriatr Soc. 1992;40:703-5. https://doi.org/10.1111/j.1532-5415.1992.tb01963.x
Goto S, Yoshioka M, Nagai K, Abe A, Murakawa E, Yamazaki N, et al. Primary hyperparathyroidism associated with multiple myeloma. Intern Med. 1995;34:988-91. https://doi.org/10.2169/internalmedicine.34.988
Arnulf B, Bengoufa D, Sarfat i E, Toubert ME, Meignin V, Brouet JC, et al. Prevalence of monoclonal gammapathy in patient s with primary hyperparathyroidism. Arch Intern Med. 2002;162:464-7. https://doi.org/10.1001/archinte.162.4.464
Mundis RJ, Kyle RA. Primar y hyperparat hyroidism and monoclonal gammopathy of undetermined significance. Am J Clin Pathol. 1982;77:619-21. https://doi.org/10.1093/ajcp/77.5.619
Lundgren E, Hagstrom EG, Lundin J, Winnerbäck K, Roos J, Ljunghall S, et al. Primary hyperparathyroidism revisited in menopausal women with serum calcium in the upper normal range at population-based screening 8 years ago. World J Surg. 2002;26:931-6. https://doi.org/10.1007/s00268-002-6621-0
Conte G, Figueroa G, Lois V, Cabrera ME, León A, García H, et al. Mieloma múltiple en Chile. Características clínicas y sobrevida. Rev Méd Chile. 2007;135:1111-7. https://doi.org/10.4067/S0034-98872007000900003
Danese M, Kim J, Doan Q, Dylan M, Griffi ths R, Chertow G. PTH and the risks for hip, vertebral, and pelvic fractures among patients on dialysis. Am J Kidney Dis. 2006;1:149-56. https://doi.org/10.1053/j.ajkd.2005.09.024
Kaji H, Yamauchi M, Chihara K, Sugimoto T. The t hreshold of bone mineral densit y for vertebral fractures in female patient s with primary hyperparat hyroidism. Eur J Endocr. 2005;153:373-8. https://doi.org/10.1530/eje.1.01985
Marcocci C, Cetani F. Primary hyperparathyroidism. N Engl J Med. 2011;365:2389-97. https://doi.org/10.1056/NEJMcp1106636
Boonen S, Bischoff-Ferrari HA, Cooper C, Lips P, Lj unggren O, Meunier PJ, et al. Addressing the musculoskeletal components of fracture risk with calcium and vitamin D: a review of the evidence. Calcif Tissue Int. 2006;78:257-70. https://doi.org/10.1007/s00223-005-0009-8
Conroy S, Moulias S, Wassif WS. Primary hyperparathyroidism in the older person. Age Ageing. 2003;32:571-8. https://doi.org/10.1093/ageing/afg122
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Revista Colombiana de ortopedia y traumatología
This work is licensed under a Creative Commons Attribution 3.0 Unported License.
