Parathyroid Adenoma with Coeliac Disease: Primary or Quaternary Hyperparathyroidism?

This case report described 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 levels, 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, with the onset of puberty. The report suggested that chronic stimulation from untreated coeliac disease could lead to tertiary hyperparathyroidism and potentially progress to adenoma formation, termed "quaternary hyperparathyroidism." Further studies were recommended to explore the relationship between coeliac disease and hyperparathyroidism.