I. Schafhalterzoppoth et al., CORONARY-ARTERY DISEASE AS 1ST MANIFESTAT ION OF PRIMARY HYPERPARATHYROIDISM, Wiener Klinische Wochenschrift, 106(16), 1994, pp. 527-530
Due to unstable angina pectoris coronary arteriography was performed i
n a 57 year-old female, showing diffuse 3-vessel disease; aortocoronar
y bypass surgery was recommended. During routine pre-operative examina
tion hypercalcemia, as well as an elevated value of parathormone were
observed. Ultrasonography of the parathyroid glands showed two enlarge
d cranial glands. In a simultaneous surgical procedure 4 bypass grafts
were performed and 4 hyperplastic parathyroid glands were removed, on
e of which was re-operated as an auto-transplantation in the left musc
ulus adductor magnus. Histological examination showed water clear cell
hyperplasia of the parathyroid glands. Though the patient had suffere
d from stomach and duodenal ulcers and nephrolithiasis over several ye
ars, primary hyperparathyroidism was diagnosed only after angiographic
ally proven coronary artery disease.