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 and excision of the parathyroid adenoma normalized her calcium levels and initiated puberty. The case suggested a potential progression from tertiary hyperparathyroidism to adenoma formation, termed "quaternary hyperparathyroidism," highlighting the need for further studies on the relationship between coeliac disease and hyperparathyroidism.