Surgical treatment of primary hyperparathyroidism in children: report of 10 cases.
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.
Third Department of Surgery, First Faculty of Medicine and Teaching Hospital Motol, V Uvalu 84, 150 06 Prague 5, Czech Republic.
Petr
P
Libánský
Jaromír
J
Astl
Svatopluk
S
Adámek
Ondrej
O
Nanka
Pavel
P
Pafko
Jana
J
Spacková
René
R
Foltán
Jirí
J
Sedý
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood; D002648:Child; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000601:surgery*; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D016896:Treatment Outcome
D015415:Biomarkers; D010281:Parathyroid Hormone; D002118:Calcium