Case Report: Unusual electrolyte changes in primary hyperparathyroidism—a call to suspect underlying Gitelman syndrome - Takeaways - MDSpire

Case Report: Unusual electrolyte changes in primary hyperparathyroidism—a call to suspect underlying Gitelman syndrome

  • By

  • Dasili Wickramasinghe Aruna Shantha

  • Sasmitha Ravindu Waidyatilleke

  • Kanishka Piumi Senevirathne

  • Ravindran Dhanushkar

  • Kushalee Poornima Jayawickreme

  • Buddika K. Dassanayake

  • Chamara Dalugama

  • Manoji Pathirage

  • June 19, 2026

  • 0 min

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  • 1

    Primary hyperparathyroidism (PHPT) typically presents with hypercalcemia, hypophosphatemia, and hypercalciuria, but can also involve rare electrolyte abnormalities.

  • 2

    A 74-year-old woman exhibited severe hypercalcemia, hypokalemia, and hypomagnesemia, resistant to hydration and electrolyte replacement, indicating a complex etiology.

  • 3

    Urine analysis revealed renal potassium and magnesium wasting alongside severe hypocalciuria, raising suspicion for underlying renal tubulopathy.

  • 4

    Vitamin D deficiency was confirmed in the patient, and imaging revealed a parathyroid adenoma, leading to surgical intervention.

  • 5

    Postoperatively, while hypercalcemia resolved, persistent hypomagnesemia suggested the presence of Gitelman syndrome as a possible underlying condition.

Original Source(s)

Case Report: Unusual electrolyte changes in primary hyperparathyroidism—a call to suspect underlying Gitelman syndrome

  • by Dasili Wickramasinghe Aruna Shantha, Sasmitha Ravindu Waidyatilleke, Kanishka Piumi Senevirathne, Ravindran Dhanushkar, Kushalee Poornima Jayawickreme, Buddika K. Dassanayake, Chamara Dalugama, Manoji Pathirage

  • June 19, 2026

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