Primary Hyperparathyroidism Presenting as Fever of Unknown Origin with Unremitting Headache

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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

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