Primary Hyperparathyroidism Presenting as Fever of Unknown Origin with Unremitting Headache

Excerpt

Hyperparathyroidism, classically characterized by hypercalcemia, bone demineralization, and nephrolithiasis, is increasingly associated with more protean manifestations (1). We describe a patient with a parathyroid adenoma who presented with fever and intractable headache persisting for over a year before hyperparathyroidism was diagnosed. Headache as a major manifestation of hyperparathyroidism is rare, and, to our knowledge, presentation of the disease as fever of unknown origin has not been reported previously (1-4).

A 29-year-old white woman presented to the clinic of the University of Michigan Medical Center in March 1972 with bilateral, dull, nonpulsatile temporal and frontal headaches dating from an upper respiratory