Primary hyperparathyroidism in children is very rare. It is caused by overproduction of parathormone by a pathologically changed parathyroid gland. We carried out a retrospective study in 10 patients (age 10-17 years) who had surgical treatment between 1996 and 2007. The main signs of primary hyperparathyroidism were urolithiasis, nephrolithiasis, nephrocalcinosis and bone resorption, as well as non-specific signs such as fatigue, torpidness and muscle weakness. Patients were examined using sonography, MIBI-scintigraphy, CT and MRI. Calcium was measured before and after surgery; parathormone was monitored postoperatively. Surgery was curative in nine patients; reoperation was necessary in one patient because an ectopic parathyroid gland was not detected during the primary operation. Other major complications were not observed. Removal of pathologically changed parathyroid glands offers definitive and safe treatment of primary hyperparathyroidism in children. Special care should be taken if an ectopic parathyroid gland is suspected.
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http://dx.doi.org/10.1016/j.ijporl.2008.04.005 | DOI Listing |
J Endocr Soc
January 2025
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK.
Purpose: To describe diagnostic approaches and management strategies for patients with primary hyperparathyroidism (PHPT) and recent fracture in England.
Methods: We developed a survey based on a patient at high fracture risk and a new diagnosis of probable PHPT. The survey was circulated among 50 secondary care professionals identified by the Society for Endocrinology Calcium and Bone special interest group.
Clin Endocrinol (Oxf)
January 2025
Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, J&K, India.
Background: Primary hyperparathyroidism (PHPT) is associated with hypertension, left ventricular hypertrophy, and myocardial and valvular calcifications, leading to increased mortality rates. While the association between PHPT and diastolic dysfunction has been well-documented, data on systolic dysfunction and its reversal after curative parathyroidectomy (PTX) remains limited.
Purpose: To evaluate the effect of PTX on cardiovascular parameters, especially systolic dysfunction, in PHPT patients using conventional and speckle-tracking echocardiography (STE).
Clin Nucl Med
January 2025
From the Nuclear Medicine Unit, Department of Diagnostic and Interventional Radiology, Queen Elizabeth Hospital, Hong Kong.
A 77-year-old woman was diagnosed with primary hyperparathyroidism, and initial cervical ultrasonography found no parathyroid lesion, and she was referred to the nuclear medicine unit for dual-phase 99mTc-sestamibi (MIBI) scan. The scintigraphy unveiled heterogeneous uptake patterns across bilateral thyroid lobes, corresponding to the thyroid nodules, alongside a marked focal uptake with delayed tracer washout in the right oral region. The SPECT/CT pinpointed a MIBI-avid nodule within the right parapharyngeal space, indicative of parathyroid ectopia.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Internal Medicine, Bursa Sehir Training and Research Hospital, University of Health Sciences, Bursa, Turkey.
Primary hyperparathyroidism (pHPT) is marked by mineral imbalances, often leading to nephrolithiasis and osteoporosis. While imaging remains the cornerstone for stone detection, there is growing interest in biochemical markers that could enhance diagnostic accuracy. This study investigates the calcium-to-magnesium (Ca/Mg) ratio as a novel biomarker for nephrolithiasis, comparing its utility to traditional 24-h urinary calcium excretion and exploring its broader clinical implications.
View Article and Find Full Text PDFSurgery
January 2025
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA; Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, PA; Leonard David Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Division of Endocrine and Oncologic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA.
Background: A shift toward outpatient parathyroidectomy was seen in the early 2000s. Recent trends, especially for secondary and tertiary hyperparathyroidism, have not been described. This study evaluates temporal trends in same-day, overnight, and inpatient parathyroidectomy by surgical indication.
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