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Diagnostic yield of parathyroid hormone testing in children evaluated for hypercalciuria
Christina Lo1, Yael Zucker, Bernard G Gauthier
1Department of Pediatrics, Division of Nephrology, Schneider Children's Hospital of the North Shore-Long Island Jewish Health System, New Hyde Park, NY 11040, USA.
Insights
Measuring parathyroid hormone (PTH) in children with hypercalciuria rarely identifies primary hyperparathyroidism. However, due to the condition
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Urology
Background:
- Hypercalciuria frequently causes non-glomerular hematuria in children.
- Primary hyperparathyroidism can be a secondary cause of hypercalciuria.
- Serum parathyroid hormone (PTH) measurement is often used to investigate pediatric hypercalciuria.
Purpose of the Study:
- To evaluate the diagnostic utility of serum PTH level measurements in pediatric patients presenting with hypercalciuria.
- To determine the yield of PTH testing in identifying primary hyperparathyroidism in this cohort.
Main Methods:
- Retrospective chart review of pediatric patients.
- Analysis of serum PTH levels in children with newly diagnosed hypercalciuria.
- Data collected over a 30-month period (January 1, 2001, to September 30, 2003).
Main Results:
- 31 children underwent PTH level determination.
- Only 1 patient (3%) showed an elevated PTH level.
- The diagnostic yield of PTH measurement for primary hyperparathyroidism was low in this study.
Conclusions:
- Serum PTH level measurement has a low diagnostic yield for primary hyperparathyroidism in pediatric patients with newly diagnosed hypercalciuria.
- Despite the low yield, the serious consequences of untreated primary hyperparathyroidism warrant continued consideration of PTH testing.
- Further research may be needed to optimize the diagnostic strategy for hypercalciuria in children.
Abstract:
Hypercalciuria is a frequent cause of non-glomerular hematuria in pediatric patients. Because hypercalciuria can be secondary to primary hyperparathyroidism, measurement of serum parathyroid hormone (PTH) levels is often performed in children with this urinary abnormality. A retrospective chart review was performed to determine the diagnostic yield of PTH measurements when performed under these clinical circumstances. Over a 30-month period (January 1, 2001 to September 30, 2003), among 31 children who had a PTH determination, the level was elevated in 1 (3%) patient. Based on these findings and the serious nature of untreated primary hyperparathyroidism, serum PTH level should be measured in pediatric patients with newly diagnosed hypercalciuria.
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