Jonette M Bartlett, Thanh D Hoang and Alfred F Shwayhat
A 44 year-old female presented with one-year-history of fatigue, irritability, forgetfulness, and esophageal reflux. She was taking lisinopril for hypertension and atorvastatin for hyperlipidemia. She had no pertinent family medical history. Physical examination was normal. Laboratory results: serum calcium 11.0 (8.9-10.3 mg/dL), albumin 3.8 (3.5-5.0 mg/dL), PTH intact 167 (ref 10-65 pg/mL), phosphate 2.1(2.5-4.6 mg/dL), 25-hydroxy-Vitamin D 11 (30-100 ng/mL). Tc-99m MIBI scan suggested a right inferior parathyroid adenoma (Figure 1A). Bilateral neck exploration failed to identify parathyroid adenoma. Postoperatively PTH 184 pg/ mL, phosphate 2.2 mg/dL, calcium 11.1 mg/dL.
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