Windswept Deformity: A Rare Skeletal Manifestation in an Adolescent with Primary Hyperparathyroidism.

J ASEAN Fed Endocr Soc

Department of General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India.

Published: December 2024

AI Article Synopsis

  • Primary hyperparathyroidism (PHPT) in adolescents is uncommon and typically leads to more severe symptoms than in adults, with skeletal issues being rare and mostly documented in case studies.
  • A unique case is reported of a 19-year-old male with a windswept deformity, characterized by the bending of his legs at the knee, who was diagnosed with PHPT after showing elevated calcium and parathyroid hormone levels.
  • After identifying and surgically removing a parathyroid adenoma, the patient's calcium and parathyroid hormone levels returned to normal, and he is now scheduled for corrective surgery once his alkaline phosphatase stabilizes.

Article Abstract

Primary hyperparathyroidism (PHPT) in adolescents is rare and has severe manifestations as compared to adults. Skeletal involvement in primary hyperparathyroidism in the form of deformities like genu valgus, genu varus and cubitus varus is rare and limited to case reports and case series. There is only one case of genu varus with genu valgus on the contralateral extremity (windswept deformity) that has been reported to date in the literature. We report the case of a 19-year-old male who presented with isolated progressive bending of his legs at the knee (windswept deformity) for three years. He was found to have hypercalcemia, hypophosphatemia, high alkaline phosphatase, high intact parathyroid hormone (iPTH), normal 25-hydroxy vitamin D level and a normal kidney function test. A diagnosis of primary hyperparathyroidism was made. On imaging studies, a left inferior parathyroid adenoma was localized and was successfully removed surgically. Serum calcium and iPTH normalized post-operatively. The patient is being planned for corrective osteotomy after stabilization of alkaline phosphatase levels.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604362PMC
http://dx.doi.org/10.15605/jafes.039.02.10DOI Listing

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