PMID: 9642634Jun 27, 1998Paper

Primary hyperparathyroidism in children: patient report and review of the literature

Journal of Pediatric Endocrinology & Metabolism : JPEM
D DamianiN Setian

Abstract

Although primary hyperparathyroidism has rarely been described in pediatric patients, prompt diagnosis can avoid severe CNS and metabolic consequences. The aim of this paper is to report a 6 year-old girl whose first symptoms began at eight days of age with cyanosis, hypotonia, and upward gaze deviation. At 4 months, she was admitted due to neurologic disorders and recurrent infection, but the definite diagnosis was made only six years later. Her serum calcium levels are among the highest ever reported in the medical literature, reaching 25.5 mg/dl (6.36 mmol/l). Hypercalcemia, very high levels of parathormone (1550 ng/l--normal range 10-65) and bone deformities posed no problem to diagnosis when she first came to our attention. Nephrocalcinosis and impaired renal function were detected and this child had to be treated with diuretics (furosemide) and hydration that were able to lower her serum calcium levels. Imaging studies including 99mTc-sestamibi scan were not diagnostic. At surgery, the four parathyroid glands were mildly enlarged, with primary hyperplasia. The four glands were removed, cryopreserved, and 14 fragments (1 mm each) were autotransplanted to the braquioradial muscle of the left forearm. After a first phase of ...Continue Reading

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Citations

Jul 6, 2010·Current Opinion in Pediatrics·Steven A LietmanMichael A Levine
Dec 12, 2012·Case Reports in Endocrinology·B DhamijaG A Solanki
Oct 1, 2011·Kidney International·Sandra HabbigBernd Hoppe
Jul 30, 2016·Oxford Medical Case Reports·Shruti Sharma, Sunil Kumar
Apr 5, 2005·Pediatrics·Josh KollarsDavid Rodeberg

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