Can Diabetes Associated With Hyperparathyroidism Be an Additional Indication for Parathyroidectomy?

rimary hyperparathyroidism is not un-common. It has varied presentations ranging from asymptomatic disease to the classic “stones, groans, moans”. This is a case report of a 49 year-old woman, who presented with sensory obtunda-tion, abdominal pain, associated with vomiting and denovo detected diabetes mellitus. She had a past history of bilateral nephrolithiasis, and was found to have hypercalcemia (serum cor-rected calcium 12.8 mg/dL) with elevated serum intact parathormone (183 pg/mL, normal range 13-54 pg/mL). The 99m-Tc MIBI scintigraphy lo-calized the source of parathormone to the right inferior parathyroid gland. Being dehydrated, she was treated with saline diuresis, salmon cal-citonin and intravenous pamidronate. Her blood sugar was reported to be 421 mg/dL, and the gly-cemia was controlled with insulin therapy. A 2 X 2 cm sized right inferior parathyroid adenoma was later removed. The glycemic status im-proved dramatically after parathyroidectomy and the patient was euglycemic on low doses of glimepiride. This case study suggests that pri-mary hyperparathyroidism might also contribute to hyperglycemia in subjects with diabetes mel-litus