Primary Hyperparathyroidism due to Parathyroid Adenoma in Children and Adolescents

Endocr Pract. 2024 Mar 29:S1530-891X(24)00473-7. doi: 10.1016/j.eprac.2024.03.390. Online ahead of print.

Abstract

Objective: In contrast to adults, primary hyperparathyroidism (PHPT) in children and adolescents is a rare endocrine disorder.

Methods: A retrospective review of PHPT cases between 2005 and 2022 from a single tertiary university medical center, including clinical signs and symptoms, laboratory findings, radiological evaluation, treatment, and postoperative complications.

Results: Ten children (mean age at diagnosis 16.3 ± 1.3 years) were diagnosed with PHPT. All patients were in late pubertal stages without sex predominance and 8 were symptomatic. Mean calcium level was 13.6 ± 2.5 mg/dL, and mean parathyroid hormone levels were 204.8 ± 163.1 pg/mL. Parathyroid adenoma was confirmed by the postsurgical pathology results.

Conclusions: PHPT in children and adolescents is often symptomatic and more severe than adults. The main cause is single parathyroid adenoma. Associated hypercalcemic syndromes were not found. Patients were cured after surgical removal of the adenoma without significant postoperative complications and no recurrence during 10.4 ± 5.9 years follow-up.

Keywords: hypercalcemia; hyperparathyroidism; parathyroid adenoma.