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Sporadic primary hyperparathyroidism in young patients: a separate disease entity?

C R Harman1, J A van Heerden, D R Farley

  • 1Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA.

Archives of Surgery (Chicago, Ill. : 1960)
|June 15, 1999
PubMed
Summary
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Primary hyperparathyroidism (1 HPT) in young patients is often severe, presenting with significant symptoms and biochemical abnormalities. Surgical intervention remains a safe and effective treatment for this condition in adolescents.

Area of Science:

  • Endocrinology
  • Pediatric Surgery

Background:

  • Sporadic primary hyperparathyroidism (1 HPT) is considered rare in individuals under 19.
  • Limited data exists on the incidence and characteristics of 1 HPT in pediatric populations.

Purpose of the Study:

  • To investigate the clinical presentation, pathology, and outcomes of sporadic 1 HPT in young patients.
  • To assess the long-term efficacy and safety of surgical management for 1 HPT in this age group.

Main Methods:

  • Retrospective review of 33 patients (aged 9-19) undergoing surgery for sporadic 1 HPT between 1976 and 1998.
  • Data collected included clinical symptoms, biochemical markers, surgical findings, pathology, and patient follow-up.

Main Results:

  • 94% of patients were symptomatic, with renal stones (42%) and bone disease (27%) being most common.

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  • Patients presented with significantly elevated serum calcium (mean 3.02 mmol/L) and large parathyroid adenomas (mean 967 mg).
  • 94% achieved postoperative normocalcemia; 15% required re-exploration for persistent/recurrent disease. No inherited disorders were identified.

    • Conclusions:

    • 1 HPT in young patients often manifests as a severe condition with pronounced symptoms and biochemical derangements.
    • Physicians should consider 1 HPT in adolescents presenting with diverse symptoms, even in non-familial cases.
    • Surgical treatment is effective and safe for managing 1 HPT in the pediatric population, similar to adults.