Primary Hyperparathyroidism in 9/11 First Responders

Abstract

Primary Hyperparathyroidism is an unfortunate consequence in 9/11 first responders that is being overlooked. Survivors of that tragic day may have to live with a long list of comorbidities, however, hyperparathyroidism due to parathyroid adenomas is a well-known outcome. Heightened awareness of the disease and its prevalence should promote a lower threshold for suspicion in 9/11 first responders, leading to frequent screening and appropriate management of the disease before they become poor surgical candidates. Currently, the World Trade Center Health Program does not recognize hyperparathyroidism as a condition of concern. We aim to raise awareness for the screening for hyperparathyroidism in the 9/11 survivor and responder population. This is a case report of a 90-year-old male who was found to have asymptomatic hypercalcemia that was overlooked and presented years later to his primary care physician with complaints of recurrent kidney stones and new-onset paroxysmal A. fib in the setting of newly diagnosed hyperparathyroidism which is likely secondary to 9/11 ground zero occupational exposure for over 2 years. This case report has the objective to encourage clinicians to include hyperparathyroidism in the differential diagnosis of 9/11 first responders.