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Hyperparathyroid crisis in a pediatric patient.

Diana Mitchell1, Leonard P Rybak, Frank R Glatz

  • 1Department of Surgery, Division of Otolaryngology, School of Medicine, Southern Illinois University, 747 N. Rutledge, P.O. Box 19653, Springfield, IL 62794-9653, USA.

International Journal of Pediatric Otorhinolaryngology
|January 17, 2004
PubMed
Summary

Primary hyperparathyroidism is rare in children. This case highlights delayed diagnosis leading to severe bone disease, including pathological fractures and brown tumors, emphasizing the need for early recognition in pediatric patients.

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Area of Science:

  • Pediatric Endocrinology
  • Skeletal Diseases
  • Calcium Metabolism

Background:

  • Primary hyperparathyroidism (PHPT) is uncommon in pediatric populations.
  • Delayed diagnosis of PHPT in children can result in significant skeletal complications.
  • Vague presenting symptoms often contribute to diagnostic delays.

Observation:

  • A 13-year-old female presented with a pathological femur fracture.
  • The patient exhibited numerous brown tumors, indicative of advanced bone disease.
  • These findings suggested a rare case of pediatric primary hyperparathyroidism.

Findings:

  • The case confirmed primary hyperparathyroidism as the underlying cause of the patient's severe bone manifestations.
  • Diagnostic challenges in pediatric PHPT were evident due to nonspecific symptoms.

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  • Severe skeletal involvement, including osteitis fibrosa cystica, was noted.

    • Implications:

    • Early diagnosis of pediatric primary hyperparathyroidism is crucial to prevent severe skeletal morbidity.
    • Increased clinical awareness is needed for recognizing PHPT in children presenting with bone abnormalities.
    • This case underscores the importance of considering rare endocrine disorders in pediatric fracture cases.