title: Primary hyperparathyroidism in children and young adults:--a single institution experience.
abstract: BACKGROUND
  Primary hyperparathyroidism (PHPT) is an extremely rare disorder in children and young adults. In the literature, only small case series or case reports can be found. The aim of this study was to show our experience in the management of PHPT patients under the age of 20.
  
  
  METHODS
  We performed a retrospective study of PHPT patients who underwent surgery in our institution. From 2004 to 2010, 522 patients underwent surgery (74, male; 478, female). Of these, 7 patients were under the age of 19 (4 [5%], male, 3 [0.6%], female). The following was analyzed demographic characteristics, length of the disease, clinical presentation, and preoperative and postoperative parathyroid hormone (PTH) and serum calcium levels. Ultrasonography, scintigraphy, and computerized tomography were performed for preoperative localization, and the types of operations and histopathological findings were assessed.
  
  
  RESULTS
  The average age of the patients was 15.7 years. Average duration of disease was 4.8 months. Only 2 patients (28%) were asymptomatic. The mean serum calcium level was 3.06 mmol/l, and the mean PTH level was 620.6 pg/ml. Both parameters showed significant reduction after surgery. One patient was positive for multiple endocrine neoplasia type I syndrome, while the other patients were sporadic. Five parathyroidectomies (72%), 1 double parathyroidectomy (14%), and 1 subtotal parathyroidectomy (14%) were performed.
  
  
  CONCLUSIONS
  PHPT in children and young adults is rare. It occurs more frequently in young adults than in children, with slight predominance in males. Most of the patients are symptomatic at diagnosis. Surgery is a successful method of treatment.
authors.affiliation: Center for Endocrine Surgery, Clinic of Endocrinology, Clinical Center of Serbia, University of Belgrade, Serbia.
authors.forename: I
authors.initials: I
authors.lastname: Paunovic
authors.forename: V
authors.initials: V
authors.lastname: Zivaljevic
authors.forename: R
authors.initials: R
authors.lastname: Stojanic
authors.forename: N
authors.initials: N
authors.lastname: Kalezic
authors.forename: M
authors.initials: M
authors.lastname: Kazic
authors.forename: A
authors.initials: A
authors.lastname: Diklic
mesh_terms: D000293:Adolescent; D002118:Calcium / Q000097:blood; D002648:Child; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000379:methods; D012189:Retrospective Studies
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium