PDF(Pubmed)
Abstract：
UNASSIGNED: Although common in adults, primary hyperparathyroidism (PHPT) is a rare condition in children with the most common etiology being solitary parathyroid adenoma (PTA). The typical presentation is symptomatic hypercalcemia. Management of PHTP secondary to PTA requires excision of the adenoma.
UNASSIGNED: A 13-year-old adolescent boy presented because of orbital cellulitis and was noted to have hypercalcemia. Despite this, the patient was curiously asymptomatic. Further investigations yielded an elevated parathyroid hormone (PTH) level and a normal urine calcium-to-creatinine ratio making the most likely cause of hypercalcemia PHTP secondary to PTA. Imaging demonstrated PTA. The patient underwent parathyroidectomy with the pathology demonstrating PTA. Postoperatively, the PTH levels were undetectable; hence, the patient was treated with calcitriol and calcium supplementation for 1 month and 4 months, respectively. Genetic work-up for multiple endocrine neoplasia 1 and rearranged during transfection mutations was negative.
UNASSIGNED: Solitary PTA is the most common cause of PHPT. Adenomas are mostly sporadic or may be a manifestation of an inheritable syndrome, such as multiple endocrine neoplasia. Although symptomatic disease is more common in children, our patient denied any hypercalcemia symptoms. The distinguishing biochemical feature of PHPT because of PTA is high or inappropriately normal PTH level in the context of high-normal or elevated serum calcium levels. Urinary calcium excretion is usually normal or high. PTAs are localized by ultrasound and Tc-99m-Sestamibi scintigraphy. Management includes parathyroidectomy and monitoring for postoperative hypocalcemia.
UNASSIGNED: In a child or adolescent presenting with hypercalcemia and elevated PTH levels, it is important to consider PHPT secondary to PTA, because an early diagnosis will aid in preventing complications from hypercalcemia.
UNASSIGNED: A 13-year-old adolescent boy presented because of orbital cellulitis and was noted to have hypercalcemia. Despite this, the patient was curiously asymptomatic. Further investigations yielded an elevated parathyroid hormone (PTH) level and a normal urine calcium-to-creatinine ratio making the most likely cause of hypercalcemia PHTP secondary to PTA. Imaging demonstrated PTA. The patient underwent parathyroidectomy with the pathology demonstrating PTA. Postoperatively, the PTH levels were undetectable; hence, the patient was treated with calcitriol and calcium supplementation for 1 month and 4 months, respectively. Genetic work-up for multiple endocrine neoplasia 1 and rearranged during transfection mutations was negative.
UNASSIGNED: Solitary PTA is the most common cause of PHPT. Adenomas are mostly sporadic or may be a manifestation of an inheritable syndrome, such as multiple endocrine neoplasia. Although symptomatic disease is more common in children, our patient denied any hypercalcemia symptoms. The distinguishing biochemical feature of PHPT because of PTA is high or inappropriately normal PTH level in the context of high-normal or elevated serum calcium levels. Urinary calcium excretion is usually normal or high. PTAs are localized by ultrasound and Tc-99m-Sestamibi scintigraphy. Management includes parathyroidectomy and monitoring for postoperative hypocalcemia.
UNASSIGNED: In a child or adolescent presenting with hypercalcemia and elevated PTH levels, it is important to consider PHPT secondary to PTA, because an early diagnosis will aid in preventing complications from hypercalcemia.
摘要：
■虽然在成人中很常见，原发性甲状旁腺功能亢进（PHPT）是儿童的罕见疾病，最常见的病因是孤立性甲状旁腺腺瘤（PTA）。典型表现为有症状的高钙血症。PTA继发的PHTP的管理需要切除腺瘤。
■一名13岁的青少年男孩因眼眶蜂窝织炎而出现，并被发现患有高钙血症。尽管如此,该患者奇怪地无症状。进一步的研究发现甲状旁腺激素（PTH）水平升高和尿钙与肌酐之比正常，这很可能是PTA继发的高钙血症PHTP的原因。成像显示PTA。患者接受了甲状旁腺切除术，病理显示为PTA。术后,PTH水平检测不到；因此，患者接受骨化三醇和钙补充剂治疗1个月和4个月，分别。多发性内分泌瘤形成1和在转染突变期间重排的遗传检查是阴性的。
■单发PTA是PHPT的最常见原因。腺瘤大多是散发性或可能是遗传性综合征的表现，如多发性内分泌瘤。尽管症状性疾病在儿童中更为常见，我们的患者否认有任何高钙血症症状.由于PTA引起的PHPT的区别生化特征是在正常或升高的血清钙水平高的情况下PTH水平高或不适当正常。尿钙排泄通常正常或高。PTA通过超声和Tc-99m-Sestamibi闪烁显像进行定位。管理包括甲状旁腺切除术和术后低钙血症监测。
■在出现高钙血症和PTH水平升高的儿童或青少年中，重要的是要考虑PHPT次要于PTA，因为早期诊断有助于预防高钙血症的并发症.
■一名13岁的青少年男孩因眼眶蜂窝织炎而出现，并被发现患有高钙血症。尽管如此,该患者奇怪地无症状。进一步的研究发现甲状旁腺激素（PTH）水平升高和尿钙与肌酐之比正常，这很可能是PTA继发的高钙血症PHTP的原因。成像显示PTA。患者接受了甲状旁腺切除术，病理显示为PTA。术后,PTH水平检测不到；因此，患者接受骨化三醇和钙补充剂治疗1个月和4个月，分别。多发性内分泌瘤形成1和在转染突变期间重排的遗传检查是阴性的。
■单发PTA是PHPT的最常见原因。腺瘤大多是散发性或可能是遗传性综合征的表现，如多发性内分泌瘤。尽管症状性疾病在儿童中更为常见，我们的患者否认有任何高钙血症症状.由于PTA引起的PHPT的区别生化特征是在正常或升高的血清钙水平高的情况下PTH水平高或不适当正常。尿钙排泄通常正常或高。PTA通过超声和Tc-99m-Sestamibi闪烁显像进行定位。管理包括甲状旁腺切除术和术后低钙血症监测。
■在出现高钙血症和PTH水平升高的儿童或青少年中，重要的是要考虑PHPT次要于PTA，因为早期诊断有助于预防高钙血症的并发症.
