title: Rare case of nephrocalcinosis in a 14-year-old girl: Questions.
abstract: A 14-year-old Caucasian girl with a history of primary hypoparathyroidism and unstable calcium and phosphorus levels and on ongoing treatment was admitted to the Department of Pediatric Nephrology because of the onset of nephrocalcinosis and difficulties achieving normocalcemia. Coexistence of hypoparathyroidism, oral candidiasis, dental enamel hypoplasia, and subclinical Hashimoto's disease was strongly suggestive for autoimmune polyglandular syndrome (APS) type I. One of the clinical implications of this diagnosis is the high probability of future occurrence of adrenal insufficiency and hence the importance of maintaining a high level of suspicion in case of the onset of symptoms like weakness, fainting, hypotonia, or hyperkaliemia. Addison's disease would, in fact, be quite challenging for the future management of this patient.This clinical quiz highlighted the importance of careful evaluation of all multiorgan symptoms occurring in a patient to prevent further complications.
authors.affiliation: Department of Pediatric Nephrology with Dialysis Division for Children, Public Clinical Hospital No. 1, ul. 3 Maja 13/15, 41-800, Zabrze, Poland.
authors.forename: Omar
authors.initials: O
authors.lastname: Bjanid
authors.affiliation: Chair and Clinical Department of Pediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13/15, 41-800, Zabrze, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Adamczyk
authors.affiliation: Chair and Clinical Department of Pediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13/15, 41-800, Zabrze, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Stojewska
authors.affiliation: Department of Pediatric Nephrology with Dialysis Division for Children, Public Clinical Hospital No. 1, ul. 3 Maja 13/15, 41-800, Zabrze, Poland.
authors.forename: Dagmara
authors.initials: D
authors.lastname: Roszkowska-Bjanid
authors.affiliation: Department of Pediatric Nephrology with Dialysis Division for Children, Public Clinical Hospital No. 1, ul. 3 Maja 13/15, 41-800, Zabrze, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Paszyna-Grześkowiak
authors.affiliation: Department of Pediatric Nephrology with Dialysis Division for Children, Public Clinical Hospital No. 1, ul. 3 Maja 13/15, 41-800, Zabrze, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Jędzura
authors.affiliation: Chair and Clinical Department of Pediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13/15, 41-800, Zabrze, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Oświęcimska
authors.affiliation: Chair and Clinical Department of Pediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13/15, 41-800, Zabrze, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Ziora
authors.affiliation: Department of Pediatric Nephrology with Dialysis Division for Children, Public Clinical Hospital No. 1, ul. 3 Maja 13/15, 41-800, Zabrze, Poland.
authors.forename: Aurelia
authors.initials: A
authors.lastname: Morawiec-Knysak
authors.affiliation: Chair and Clinical Department of Pediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13/15, 41-800, Zabrze, Poland. szczep57@poczta.onet.pl.
authors.forename: Maria
authors.initials: M
authors.lastname: Szczepańska
mesh_terms: D000224:Addison Disease; D000293:Adolescent; D001327:Autoimmune Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D001479:Basal Ganglia / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007011:Hypoparathyroidism / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D007677:Kidney Function Tests; D009397:Nephrocalcinosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D016884:Polyendocrinopathies, Autoimmune; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
keywords: Autoimmune polyendocrine syndrome type 1; Children; Hypoparathyroidism; Nephrocalcinosis