Ulus Travma Acil Cerrahi Derg. 2010; 16(6): 567-570

Kýrýklarla gelen atlanmýþ primer hiperparatiroidi olgusu: Olgu Sunumu

Bora Bostan¹, Mehmet Erdem¹, Taner Güneþ¹, Cengiz Þen¹, Reþit Doðan Köseoðlu^2
1Gaziosmanpaþa Üniversitesi Týp Fakültesi Ortopedi Ve Travmatoloji Ana Bilim Dalý,Tokat
²Gaziosmanpaþa Üniversitesi Týp Fakültesi Patoloji Ana Bilim Dalý, Tokat

Bu yazýda, primer hiperparatiroidden kaynaklanan çoklu kistik lezyonlar ve kistik lezyonlar seviyesindeki patolojik femur ve karþý tibia kýrýklarý olan genç kadýn hasta bildirilmektedir. Hastanýn hikayesinde dispepsi, iþtah kaybý, miyalji, artralji, yorgunluk ve kilo kaybý gibi müphem bulgulardan dolayý 6 yýl önce hastaneye baþvurma hikayesi vardý, fakat herhangi bir hastalýk saptanmamýþtý. Zamanla iþtahsýzlýk ve zayýflamasýnýn devam ettiði, son 1 yýldýr sadece yardýmla yürüyebildiði öðrenildi. Fakat bizim incelememize kadar hastada primer hiperparatiroidi atlanmýþ idi. Kýrýklarýn, biyopsi ile osteitis fibroza sistikadan kaynaklandýðý teyit edildikten sonra intramedüller çivileme ve primer greftleme ile tedavi edildi. Kýrýklar sorunsuz bir þekilde kaynadý. Sonuç olarak, bu tür müphem þikayetleri olan hastalarýn biyokimyasal ve radyolojik yöntemlerle taranmasý ve hastalýðýn atlanmamasý oldukça önemlidir.

Anahtar Kelimeler: Kýrýk, osteitis fibroza sistika; primer hiperparatiroidizm.

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Overlooked primary hyperparathyroidism presented with fractures: case report

Bora Bostan¹, Mehmet Erdem¹, Taner Güneþ¹, Cengiz Þen¹, Reþit Doðan Köseoðlu^2
1Gaziosmanpasa University School Of Medicine, Department Orthopaedics and Traumatology, Tokat
²Gaziosmanpasa University School Of Medicine, Department of Pathology, Tokat

In the present paper, we report a female patient with multiple cystic lesions of bone arising from the primary hyperparathyroidism and pathological femur and contralateral tibia fractures at the level of these cystic lesions (osteitis fibrosa cystica). The patient’s history revealed that she was admitted to a medical center with vague symptoms such as sudden onset of dyspepsia, loss of appetite, myalgia, arthralgia, fatigue, and weight loss six years ago but no disease was diagnosed. Loss of appetite and loss of weight continued. She had been walking only by assisted ambulation for the last year. However, primary hyperparathyroidism was overlooked until our examination. The fractures were managed by interlocking nailing and grafting after confirming with biopsy that the fractures were due to osteitis fibrosa cystica. The fractures healed uneventfully. In conclusion, it is essential to evaluate patients with these vague symptoms with full biochemical screening and radiological examination for the early detection of the disease.

Keywords: Fracture, osteitis fibrosa cystica; primary hyperparathyroidism.

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ATIF KOPYALA