UNVEILING THE LINK: REVERSAL OF SCLERODERMA SYMPTOMS FOLLOWING TREATMENT OF HYPERPARATHYROIDISM – A LONGITUDINAL FOLLOW-UP STUDY

Abstract

Background: The interplay between parathyroid adenoma and localized scleroderma represents a rare clinical resentation, warranting detailed investigation to understand their association better. This study aims to explore the characteristics, diagnostic challenges, and outcomes of patients diagnosed with parathyroid adenoma alongside localized scleroderma, focusing on a unique patient cohort.
Methods: This longitudinal follow up study was conducted at the Department of Surgical Oncology, Bhopal Memorial Hospital and Research Centre, Bhopal, analysing 12 patients diagnosed with primary hyperparathyroidism, liver hemangioma, and localized scleroderma. Data were collected on demographic characteristics, clinical presentations, diagnostic findings, management strategies, and patient outcomes following surgical intervention. Laboratory investigations included measurements of serum calcium and
parathormone levels, while diagnostic imaging facilitated the identification of parathyroid adenomas and associated anomalies.
Results: The study cohort consisted predominantly of females (n=12) with a median age range of 45-60 years. Elevated serum calcium (14.4 mg/dl) and intact parathormone (211 pg/mL) levels were observed, confirming the diagnosis of parathyroid adenoma. Hemangiomas were detected in both liver lobes, and all patients presented with bilateral nephrolithiasis. Surgical excision of the adenoma led to immediate normalization of serum parathyroid hormone and calcium levels. Follow-up at 1.5 years postoperatively showed significant improvement in symptoms of hypocalcemia, hair growth, skin condition, and overall patient wellbeing. Conclusion: This study underscores the significance of thorough diagnostic evaluation in patients presenting with hypercalcemia and localized scleroderma, highlighting the potential for parathyroid adenoma as an underlying cause. Surgical excision of the adenoma offers a curative treatment option, with favourable outcomes in terms of symptom resolution and improvement in quality of life. Further research is warranted to elucidate the pathophysiological link between parathyroid adenoma and localized scleroderma.