Differences in primary hyperparathyroidism characteristics between children and adolescents.

J Pediatr Surg

Center of Endocrine Surgery, Clinical Center of Serbia, Belgrade, Serbia; School of Medicine, Belgrade University, Serbia.

Published: August 2020

AI Article Synopsis

  • This study looked at how primary hyperparathyroidism (pHPT), a disease involving the parathyroid glands, affects kids and teens differently.
  • Out of 1363 patients treated, only 14 were under 20, with more bone problems in younger kids and more kidney issues in teens.
  • The results showed kids had higher levels of calcium and a different type of parathyroid issue compared to teens, suggesting they should be treated as separate groups.

Article Abstract

Background: In children and adolescents, primary hyperparathyroidism (pHPT) is rare, associated with severe morbidity, and has different clinical characteristics than in adults. The aim of this study was to analyze differences in clinical and laboratory characteristics between children and adolescents with pHPT.

Methods: A retrospective cohort study was conducted to analyze pHPT characteristics in young patients, who have been operated at our institution. All patients were divided into two groups: group of patients ≤15 years (children) and group of patients >15 and ≤20 years (adolescents).

Results: Out of 1363 pHPT patients surgically treated during the study period, 14 patients (1%) were younger than 20 years: 6 children and 8 adolescents. Male-to-female ratio in children was 2:1, and in adolescents 1:1.7. Kidney stones were found in 62.5% of the adolescents and in none of the children patients. Bone form of the disease was the most frequent in children (in 83.1%), while in adolescents the kidney form was the most frequent (in 50%). Only 16.7% of children and 25% of adolescents did not have classical symptoms. All adolescent patients had single parathyroid adenoma, while 4 children patients had single parathyroid adenoma, one patient had hyperplasia, and one had parathyroid carcinoma. Both preoperative serum calcium and PTH levels were higher in children than in adolescents (3.87 mmol/L vs. 3.17 mmol/L; 812 ng/mL vs. 392 ng/mL, respectively). In all patients vitamin D level was low. All patients had normal postoperative values of serum calcium and PTH.

Conclusion: There is a significant difference in clinical and biochemical characteristics between children and adolescent pHPT patients. Therefore, these two groups should be analyzed and treated separately.

Type Of Study: Retrospective comparative study.

Level Of Evidence: Level III.

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Source
http://dx.doi.org/10.1016/j.jpedsurg.2019.09.023DOI Listing

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