title: The changing pattern of diagnosing primary hyperparathyroidism in young patients.
abstract: BACKGROUND
  Primary hyperparathyroidism (PHPT) is increasing in adults but rarely reported in young patients where routine blood work is obtained more judiciously. We aim to determine how PHPT is currently being diagnosed in young patients and examine surgical outcomes.
  
  
  METHODS
  We retrospectively analyzed PHPT patients 24 years of age or less who underwent parathyroidectomy from 2001 to 2014. Patients were divided into 2 time periods: 2001 to 2007 (A) and 2008 to 2014 (B). Incidentally, diagnosed patients lacked objective symptoms of PHPT and had no family history.
  
  
  RESULTS
  Forty young patients met inclusion criteria: 16 in group A and 24 in group B. Those in group A compared with group B had similar mean age, preoperative calcium, and parathyroid hormone (P > .05). Incidental diagnosis was more common in the contemporary group (42% vs 25%, P = .001).
  
  
  CONCLUSIONS
  Current diagnosis of PHPT in young patients is increasingly incidental. This trend may be attributed to the more liberal use of labs in younger patients.
authors.affiliation: Department of Surgery, University of Wisconsin, 600 Highland Ave., K3/705 CSC, Madison, WI 53792, USA. Electronic address: lou@surgery.wisc.edu.
authors.forename: Irene
authors.initials: I
authors.lastname: Lou
authors.affiliation: Department of Surgery, University of Wisconsin, 600 Highland Ave., K3/705 CSC, Madison, WI 53792, USA.
authors.forename: David F
authors.initials: DF
authors.lastname: Schneider
authors.affiliation: Department of Surgery, University of Wisconsin, 600 Highland Ave., K3/705 CSC, Madison, WI 53792, USA.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Sippel
authors.affiliation: Department of Surgery, University of Wisconsin, 600 Highland Ave., K3/705 CSC, Madison, WI 53792, USA; Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Herbert
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Surgery, University of Wisconsin, 600 Highland Ave., K3/705 CSC, Madison, WI 53792, USA; Department of Surgery, University of California at Irvine, Orange, CA, USA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Elfenbein
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D033162:Incidental Findings; D008297:Male; D016105:Parathyroidectomy; D012189:Retrospective Studies; D055815:Young Adult
keywords: Adolescent hyperparathyroidism; Pediatric hyperparathyroidism; Primary hyperparathyroidism