Related Experiment Video
Updated: Mar 16, 2026
Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy
Published on: July 14, 2023
Comparative characteristics of primary hyperparathyroidism in pediatric and young adult patients
Kristina J Nicholson1, Kelly L McCoy2, Selma F Witchel3
1Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
Insights
Primary hyperparathyroidism is rare in children but treatable with parathyroidectomy, showing high cure rates. Hereditary forms, particularly Multiple Endocrine Neoplasia type 1, require lifelong monitoring for recurrence.
Area of Science:
- Endocrinology
- Pediatric Surgery
- Genetics
Background:
- Primary hyperparathyroidism (PHPT) is uncommon in pediatric populations.
- This study compares PHPT in pediatric (<19 years) and young adult (19-29 years) patients.
Purpose of the Study:
- To compare the clinical presentation, surgical outcomes, and recurrence rates of primary hyperparathyroidism in pediatric versus young adult patients.
- To evaluate the safety and efficacy of parathyroidectomy in these age groups.
Main Methods:
- A prospectively collected database from a single institution was queried for patients under 30 years undergoing initial parathyroidectomy for PHPT.
- Data from 39 pediatric and 87 young adult patients were analyzed, comparing symptoms, operative details, and postoperative outcomes.
Main Results:
- Sporadic PHPT was less frequent in pediatric patients (74.4%) than young adults (86.2%).
- Hereditary PHPT, especially Multiple Endocrine Neoplasia type 1, was more common in pediatric patients (23%).
- Parathyroidectomy demonstrated high biochemical cure rates (97.1% pediatric, 93.6% young adult) with low complication rates and comparable recurrence rates (5.9% pediatric, 10.3% young adult), primarily linked to MEN1.
Conclusions:
- Pediatric PHPT, while often sporadic, has a higher association with hereditary forms like MEN1.
- Parathyroidectomy is a safe and effective treatment for pediatric PHPT, achieving high cure rates.
- Long-term follow-up is crucial for all patients with hereditary PHPT due to the risk of recurrence.
Background:
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.
Methods:
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.
Results:
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.
Conclusion:
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.
More Related Videos
07:12Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging
Published on: August 17, 2022
07:13Two Techniques to Create Hypoparathyroid Mice: Parathyroidectomy Using GFP Glands and Diphtheria-Toxin-Mediated Parathyroid Ablation
Published on: March 14, 2017
Related Concept Videos
00:59The Parathyroid Glands
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
01:27Adrenal Gland Disorders
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...