title: Primary hyperparathyroidism in an infant with three parathyroid glands and pulmonary calcinosis.
abstract: A 2 month-old male infant presented with severe hypercalcemia due to parathyroid hyperplasia. A total parathyroidectomy and partial heterotopic autotransplantation were carried out. Hypercalcemia recurred two months later. Normocalcemia was re-established after removing one half of the implanted tissue. Despite two separate surgical explorations and several imaging studies, including 99mTc-sestamibi scintigraphy, ultrasonography, and MRI, only three parathyroid glands were found. Severe pulmonary calcinosis has not previously been reported in children with PHPT. In conclusion, developmental variations of the parathyroid glands may be difficult to identify with present imaging techniques. This may pose difficulties in management of PHPT. The present report describes pulmonary calcinosis as a sequela which can cause additional morbidity in these infants.
authors.affiliation: Department of Pediatric Endocrinology and Metabolism, Cukurova University, Faculty of Medicine, Adana, Turkey.
authors.forename: A K
authors.initials: AK
authors.lastname: Topaloglu
authors.forename: B
authors.initials: B
authors.lastname: Yuksel
authors.forename: R
authors.initials: R
authors.lastname: Tuncer
authors.forename: N O
authors.initials: NO
authors.lastname: Mungan
authors.forename: G
authors.initials: G
authors.lastname: Ozer
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging; D002118:Calcium / Q000097:blood; D004200:Diseases in Twins; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D006961:Hyperparathyroidism / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006965:Hyperplasia; D007223:Infant; D008171:Lung Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D010280:Parathyroid Glands / Q000473:pathology* / Q000601:surgery / Q000637:transplantation; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D011247:Pregnancy; D011859:Radiography; D011877:Radionuclide Imaging; D016042:Transplantation, Heterotopic
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium