Abstract
Background
Severe presentation of primary hyperparathyroidism (PHPT) which, although, common in the Asian population, is albeit rarely encountered in the present era.
Case presentation
We present a 23-year-old lady whose symptoms began in 2016 with generalized body aches. Subsequently, her husband noticed a reduction in her height and she developed gradual protrusion of chest. Meanwhile, she conceived in November 2019 and delivered a full-term healthy baby girl. She breastfed her baby for 18 months during which her symptoms worsened. On examination, she measured only 123 cm, having lost nearly 23 cm in height. She had a short neck, pectus carinatum-like deformity of chest, protruded abdomen, kyphosis, and scoliosis. Investigations revealed PTH-dependent hypercalcemia, diffuse cortical thinning, brown tumors, codfish vertebrae, and bilateral nephrolithiasis. A diagnosis of primary hyperparathyroidism (PHPT) was made with the grave clinical picture bearing a striking resemblance to that of Captain Charles Martell, the first ever recorded case of PHPT in the world.
Conclusion
The index case highlights the fact that PHPT, if left undiagnosed and untreated, can have debilitating consequences. A high index of suspicion should be exercised while evaluating all suspected cases of metabolic bone disorders and being the third most common endocrine disorder, the possibility of PHPT should be entertained wherever appropriate.
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Rimesh Pal and Shah Ravi Jignesh are the primary authors. Sandeep Sanyasi and Shivangani Lohani helped in assimilating the data. Divya Dahiya had performed parathyroidectomy. Sanjay K. Bhadada is the corresponding author and had edited the manuscript. All the authors had approved the final version of the manuscript.
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Pal, R., Jignesh, S.R., Sanyasi, S. et al. Revisiting Captain Charles Martell: witnessing the true face of primary hyperparathyroidism even in the twenty-first century. Arch Osteoporos 17, 148 (2022). https://doi.org/10.1007/s11657-022-01187-6
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DOI: https://doi.org/10.1007/s11657-022-01187-6