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Missed Opportunity of Diagnosis and Treatment of Primary Hyperparathyroidism Lands Patient to Life Threatening Acute Necrotising Pancreatitis

Suchin Dhamnaskar, Prashant Sawarkar, Sumit Mandal, Preeti Vijayakumaran

Introduction We report this case to emphasise the importance of considering primary hyperparathyroidism as a cause of bone disease like pathological fracture and being aggressive in investigating by serum PTH assay and timely treatment. This can prevent future complications like pancreatitis. Case Report We present a case of a 30-year-old young lady who had a pathological fracture of distal radius due to primary hyperparathyroidism induced osteoclastic bone resorption. The patient presented to another hospital where malignancy was ruled out by biopsy. But the diagnosis of primary hyperparathyroidism was missed and remained untreated. Four months later she developed life-threatening acute necrotising pancreatitis with multi-organ failure. She could be salvaged but developed diabetes mellitus. After control of the acute state, she underwent parathyroidectomy for definitive treatment. Thus we emphasise the importance of considering primary hyperparathyroidism as a differential diagnosis of pathological bone fracture.