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A Hungry Bone Syndrome Predicted by 18F-Fluorocholine PET/CT

Paepegaey, Anne-Cécile MD*,†; Velayoudom, Fritz-Line MD, PhD; Housni, Selma MD*,†; Gauthé, Mathieu MD§; Groussin, Lionel MD, PhD*,†

doi: 10.1097/RLU.0000000000002676
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Predicting hungry bone syndrome (HBS) after surgical cure of primary hyperparathyroidism (PHPT) can be challenging. A 57-year-old man diagnosed with PHPT was assessed preoperatively by 18F-fluorocholine PET/CT. An intense and diffuse tracer uptake of the axial and peripheral skeleton was visualized, in addition to a pathologic uptake suggestive of hyperfunctioning parathyroid gland. After the removal of a parathyroid adenoma, a severe and prolonged HBS requiring high doses of calcium and active metabolites of vitamin D was observed. This observation suggests that intense and diffuse bone uptake on 18F-fluorocholine PET/CT could be a predictive factor for HBS in patients with PHPT.

From the *Department of Endocrinology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University

Université Paris Descartes, Sorbonne Paris Cité

Department of Endocrinology Diabetology, University Hospital of Guadeloupe, Guadeloupe

§Department of Nuclear Medicine, Tenon Hospital, Assistance Publique Hôpitaux de Paris, Paris France.

Received for publication April 17, 2019; revision accepted May 3, 2019.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Lionel Groussin, MD, PhD, Hôpital Cochin, Service d'endocrinologie et des maladies métaboliques, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France. E-mail:

Online date: July 5, 2019

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