Parathyroid Adenoma With Coeliac Disease: Primary or Quaternary Hyperparathyroidism?

This document reported a case of a 14-year-old girl with coeliac disease who presented with severe hypercalcaemia due to a parathyroid adenoma. The patient exhibited delayed puberty and growth retardation, with laboratory tests showing iron deficiency anaemia, low vitamin D, high parathyroid hormone levels, and hypercalcaemia. A gluten-free diet was initiated, and her calcium levels normalized following the excision of the parathyroid adenoma. After four months on the diet, she began to mature and enter puberty. The study suggested that autonomous four-gland hyperplasia or tertiary hyperparathyroidism might progress to adenoma formation, potentially termed "quaternary hyperparathyroidism." Further research was needed to explore the link between coeliac disease and hyperparathyroidism.