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Polydipsie, zunehmende Müdigkeit und große mediastinale Raumforderung bei einer 49-jährigen Patientin

Polydipsia, increasing fatigue and a huge mediastinal tumor in a 49-year-old woman

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Zusammenfassung

Eine 49-jährige Patientin stellte sich mit einem diffusen Beschwerdebild mit Polydipsie, seit Wochen zunehmender Müdigkeit und unspezifischen abdominellen Schmerzen vor. Bei Kalzium im Serum von 5,30 mmol/l (RB: 2,00–2,60), Parathormon von > 2500,0 ng/l (RB: 15,0–68,0) und einer mediastinalen Raumforderung wurde die Diagnose einer hyperkalzämischen Krise auf dem Boden eines primären Hyperparathyreoidismus gestellt. Nach intensivstationärer Stabilisierung erfolgte die Parathyreoidektomie eines Nebenschilddrüsenadenoms. Der postoperative Verlauf war weitgehend komplikationslos.

Abstract

A 49-year-old woman presented with unspecific symptoms including polydipsia, increasing fatigue for several weeks, and vague abdominal pain. Serum calcium (5.30 mmol/l; normal range 2.00–2.60) and parathyroid hormone levels (> 2500.0 ng/l; normal range 15.0–68.0) were extremely elevated. Imaging studies showed a huge mediastinal tumor. Based on these findings a hypercalcemic crisis caused by primary hyperparathyroidism was diagnosed. After intensive care treatment and further diagnostic procedures, the patient’s parathyroid adenoma was removed by parathyroidectomy. The postoperative course was uneventful.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Friedrich, C. Rust, G. Bischoff, J. G. Wechsler, T. Jakobs, N. Woehrle, F. Brettner, H. Winter, M. Angele und B. Wendl geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Abteilung Innere Medizin I, Krankenhaus Barmherzige Brüder München, Romanstr. 93, 80639, München, Deutschland

    T. Friedrich, C. Rust, G. Bischoff, J.G. Wechsler & B. Wendl

  2. Abteilung Radiologie, Krankenhaus Barmherzige Brüder München, München, Deutschland

    T. Jakobs & N. Woehrle

  3. Abteilung Intensivmedizin, Krankenhaus Barmherzige Brüder München, München, Deutschland

    F. Brettner

  4. Allgemein-, Viszeral-, Transplantations-. Gefäss- und Thoraxchirurgie – Campus Großhadern, Klinikum der Universität München, München, Deutschland

    H. Winter & M. Angele

Authors
  1. T. Friedrich
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  2. C. Rust
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  3. G. Bischoff
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  4. J.G. Wechsler
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  5. T. Jakobs
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  6. N. Woehrle
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  7. F. Brettner
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  8. H. Winter
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  9. M. Angele
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  10. B. Wendl
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Corresponding author

Correspondence to T. Friedrich.

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Friedrich, T., Rust, C., Bischoff, G. et al. Polydipsie, zunehmende Müdigkeit und große mediastinale Raumforderung bei einer 49-jährigen Patientin. Internist 54, 1376–1382 (2013). https://doi.org/10.1007/s00108-013-3369-6

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  • DOI: https://doi.org/10.1007/s00108-013-3369-6

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