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A case report of primary hyperparathyroidism with severe bony involvement and nephrolithiasis.

INTRODUCTION
Although the majority of patients with primary hyperparathyroidism have a relatively asymptomatic benign disorder, there are patients who have a more aggressive disorder.


CLINICAL PICTURE
We report a case of primary hyperparathyroidism presenting during pregnancy complicated by antepartum haemorrhage and severe prematurity. The diagnosis was made postpartum, when her problems rapidly progressed to result in severe neuromuscular weakness, bilateral pathological hip fractures as well as nephrolithiasis.


TREATMENT
Surgical parathyroidectomy was performed. The underlying lesion was a large solitary parathyroid adenoma with cystic elements.


CONCLUSION
Primary hyperparathyroidism is not an innocuous disease and can result in severe morbidity if left untreated.