Apparent Recurrence of Hyperparathyroidism following Quadruple Parathyroidectomy.

Recurrent hyperparathyroidism can occur following quadruple parathyroidectomy and during radical parathyroidectomy and so that future hypoparathyroidism is avoided autotransplantation of parathyroid tissue is often preformed. Herein, I describe a patient who was thought to have recurrent hyperparathyroidism following a quadruple parathyroidectomy based solely on a high intact parathyroid hormone level. The patient neither had clinical symptoms or signs of hyperparathyroidism nor did the laboratory data other than the increased intact PTH level suggest hyperparathyroidism. A more comprehensive history revealed the cause of the elevated intact PTH so that further expensive, invasive, and potentially dangerous investigations were avoided.