PDF(Pubmed)
Abstract：
Primary hyperparathyroidism is rare in children and usually presents with nonspecific symptoms. Ramadan fasting has been reported to unmask the diagnosis of primary hyperparathyroidism. A 15-year-old boy presented to the clinic for an emergency department follow up visit. He had started Ramadan fasting a week before his presentation to the clinic. He reported unintentional weight loss, abdominal pain, constipation, frequent headaches, exercise intolerance, tiredness, and palpitations. Physical examination was unremarkable except that he looked tired. Investigations revealed elevated calcium and parathyroid hormone, hypophosphatemia, low vitamin D, and parathyroid adenoma. He underwent parathyroidectomy, leading to a decrease in parathyroid hormone levels. He did well postoperatively, and by his 11-month follow-up visit, his calcium was back to a normal level, he was energetic, and had gained weight. A high index of suspicion is required to diagnose primary hyperparathyroidism in young patients, especially young Ramadan-fasting patients, who mostly present with vague nonspecific symptoms.
摘要：
原发性甲状旁腺功能亢进在儿童中很少见，通常表现为非特异性症状。据报道，斋月禁食可以揭示原发性甲状旁腺功能亢进的诊断。一名15岁的男孩到诊所接受急诊科的随访。他在去诊所就诊前一周开始斋月禁食。他报告了无意的体重减轻，腹痛,便秘,经常头痛,锻炼不容忍，疲倦,还有心悸.除了他看起来很累之外，身体检查并不引人注目。调查显示钙和甲状旁腺激素升高，低磷酸盐血症,低维生素D,和甲状旁腺腺瘤.他接受了甲状旁腺切除术,导致甲状旁腺激素水平下降。他术后做得很好，通过他11个月的随访,他的钙恢复到正常水平,他精力充沛，而且体重增加了.诊断年轻患者原发性甲状旁腺功能亢进症需要高度怀疑，尤其是斋月禁食的年轻患者，大多表现为模糊的非特异性症状。
