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Differences in primary hyperparathyroidism characteristics between children and adolescents.

Vladan Zivaljevic1, Milan Jovanovic2, Aleksandar Diklic1

  • 1Center of Endocrine Surgery, Clinical Center of Serbia, Belgrade, Serbia; School of Medicine, Belgrade University, Serbia.

Journal of Pediatric Surgery
|November 11, 2019
PubMed
Summary

Primary hyperparathyroidism (pHPT) presents differently in children and adolescents. This study found significant clinical and biochemical distinctions, suggesting separate analysis and treatment approaches are necessary for these distinct pediatric age groups.

Keywords:
AdolescentsChildrenHyperparathyroidismParathyroidectomy

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Area of Science:

  • Pediatric Endocrinology
  • Surgical Endocrinology
  • Clinical Biochemistry

Background:

  • Primary hyperparathyroidism (pHPT) is uncommon in pediatric populations, presenting with significant morbidity and distinct clinical features compared to adults.
  • Understanding these differences is crucial for accurate diagnosis and effective management in young patients.

Purpose of the Study:

  • To investigate and compare the clinical and laboratory characteristics of pHPT in children and adolescents.
  • To identify key differences that may necessitate distinct diagnostic and therapeutic strategies for these two groups.

Main Methods:

  • A retrospective comparative study analyzing data from 14 pediatric patients (<20 years) with pHPT who underwent surgery.
  • Patients were stratified into two groups: children (≤15 years) and adolescents (>15 and ≤20 years).

Main Results:

  • Children (n=6) exhibited a higher male-to-female ratio (2:1) and predominantly the bone form of pHPT (83.1%), with higher preoperative serum calcium and PTH levels.
  • Adolescents (n=8) showed a female predominance (1:1.7), a higher incidence of kidney stones (62.5%), and the kidney form of pHPT (50%).
  • All patients had low vitamin D levels; adolescent patients exclusively had single parathyroid adenomas, unlike children who had varied pathologies including carcinoma.

Conclusions:

  • Significant variations exist in clinical presentation and biochemical profiles between pediatric and adolescent pHPT.
  • Separate analysis and tailored treatment protocols are recommended for children and adolescent pHPT patients due to these distinct characteristics.