[Primary juvenile hyperparathyroidism. Report of 24 cases].
OBJECTIVE
Primary hyperparathyroidism usually affects elderly patients. Juvenile primary hyperparathyroidism is rare, and raises diagnostic and prognostic problems. The aim of this retrospective study on 24 patients is to establish clinical, histological, and therapeutic features of juvenile primary hyperparathyroidism.


METHODS
From 1986 to 2001, 673 patients were treated for primary hyperparathyroidism in our department. Twenty four patients were younger than 30 years old (3.5%). There were 14 women and 10 men. Mean age was 23 year (14-30). Clinical manifestations, pathologics findings and postoperative results were studied.


RESULTS
Sixteen patients presented a sporadic form of primary hyperparathyroidism with a single adenoma. Clinical manifestations were renal symptoms in 11 cases and acute hypercalcemia syndrome in 2 cases. Seven patients had a NEM I syndrome: parathyroid lesions were 6 hyperplasia and one adenoma. A 27 years old woman presented a recurrent familial isolated hyperparathyroidism. She was operated on 10 years before and at reoperation parathyroid carcinoma was found. Nineteen patients were cured after a post operative follow up ranging from 3 to 168 months. One patient had an asymptomatic hypercalcemia recurrence. Two patients presented permanent hypoparathyroidism treated with calcitriol and calcium.


CONCLUSIONS
Sporadic forms represent majority of cases of juvenile hyperparathyroidism. Renal manifestations are usual. Nevertheless, multiple endocrine neoplasia type 1 has to be evocated.
Monneuse
O
O
Service de chirurgie, hôpital de l'Antiquaille, 69321 Lyon, France.
Causeret
S
S
Lifante
J C
JC
Berger
N
N
Lapras
V
V
Peix
J L
JL
D000236:Adenoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002117:Calcitriol / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D002120:Calcium Channel Agonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D006961:Hyperparathyroidism / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D008297:Male; D018761:Multiple Endocrine Neoplasia Type 1 / Q000150:complications / Q000473:pathology* / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
D002120:Calcium Channel Agonists; D002117:Calcitriol; D002118:Calcium