[Primary hyperparathyroidism associated to slipped capital femoral epiphysis in a teenager].
Primary hyperparathyroidism (PHP) is an uncommon disease in children and adolescents. The association between PHP and slipped capital femoral epiphysis is rare, and so far only four cases have been reported in the literature. Herein, we report a case of PHP due to a parathyroid adenoma, with several painful skeletal deformities and associated with slipped capital femoral epiphysis in an 18-year-old male patient. Laboratory evaluation showed: calcium of 13.6 mg/dL, parathyroid hormone of 1,524 pg/mL and alkaline phosphatase of 3,449 U/L. Deformities were caused by late diagnosis during the growth spurt, and this association is the result of combinations between metabolic and mechanical factors. The patient underwent parathyroidectomy and, in agreement with the literature, since the removal of the adenoma is followed by prompt resolution of the slipped capital femoral epiphysis we decided for a conservative approach. We observed improvement of the pain and normalization of calcium and parathyroid hormone levels.
Madeira
Isabel Rey
IR
Setor de Endocrinologia Pediátrica, Unidade Docente Assistencial de Endocrinologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro. isamadeira@br.inter.net
Machado
Marise
M
Maya
Maria Cristina A
MC
Sztajnbok
Flávio Roberto
FR
Bordallo
Maria Alice N
MA
D000293:Adolescent; D004839:Epiphyses, Slipped / Q000150:complications* / Q000000981:diagnostic imaging; D005270:Femur Head / Q000000981:diagnostic imaging; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications* / Q000601:surgery; D008297:Male; D011859:Radiography