title: Comparative characteristics of primary hyperparathyroidism in pediatric and young adult patients.
abstract: Primary hyperparathyroidism is rare in pediatric patients. Our study aim was to compare primary hyperparathyroidism in pediatric (<19 years) and young adult (19-29 years) patients.
  
  
  
  A prospectively collected database from a single, high-volume institution was queried for all patients age <30 years who had initial parathyroidectomy for primary hyperparathyroidism yielding 126/4,546 (2.7%) primary hyperparathyroidism patients representing 39 pediatric and 87 young adult patients. Presenting symptoms, operative data, and postoperative course were compared for patients age 0-19 years and 20-29 years.
  
  
  
  Sporadic primary hyperparathyroidism was present in 81.7% and occurred less often in pediatric patients than young adult patients (74.4% vs 86.2%, P = .12). Among patients with hereditary primary hyperparathyroidism, multiple endocrine neoplasia type 1 was the most common type. Multiglandular disease was common in both pediatric (30.7%) and young adult (21.8%) patients. Following parathyroidectomy, 3 (2.3%) patients had permanent hypoparathyroidism and none had permanent recurrent laryngeal nerve paralysis. Biochemical cure at 6 months was equally likely in pediatric and young adult patients (97.1% vs 93.6%, P = .44) with comparable follow-up (78.4 months vs 69.1 months, P = .66) and rates of recurrent disease (5.9% vs 10.3%, P = .46). Recurrence was due to multiple endocrine neoplasia 1-related primary hyperparathyroidism in all cases.
  
  
  
  Although primary hyperparathyroidism is sporadic in most patients <19 years, they are more likely to have multiple endocrine neoplasia type 1-associated primary hyperparathyroidism (23%). Parathyroidectomy for primary hyperparathyroidism can be performed safely in pediatric patients with a high rate of cure. Follow-up for patients with hereditary disease is necessary.
authors: Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
authors: Kristina J
authors: KJ
authors: Nicholson
authors: Department of Surgery, Division of Endocrine Surgery, University of Pittsburgh, Pittsburgh, PA.
authors: Kelly L
authors: KL
authors: McCoy
authors: Department of Pediatrics, Division of Endocrinology, University of Pittsburgh, Pittsburgh, PA.
authors: Selma F
authors: SF
authors: Witchel
authors: Department of Surgery, Division of Endocrine Surgery, University of Pittsburgh, Pittsburgh, PA.
authors: Michael T
authors: MT
authors: Stang
authors: Department of Surgery, Division of Endocrine Surgery, University of Pittsburgh, Pittsburgh, PA.
authors: Sally E
authors: SE
authors: Carty
authors: Department of Surgery, Division of Endocrine Surgery, University of Pittsburgh, Pittsburgh, PA. Electronic address: yipl@upmc.edu.
authors: Linwah
authors: L
authors: Yip
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001707:Biopsy, Needle; D002648:Child; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D007150:Immunohistochemistry; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy / Q000009:adverse effects / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult