Abstract • An asymptomatic 11-year-old boy was found to have primary hyperparathyroid secondary to an isolated parathyroid adenoma. This rare disorder of childhood can have asymptomatic hypercalcemia as its only manifestation. Parathyroid hormone assays and studies of urinary calcium excretion, especially the calcium-creatlnine clearance ratio, distinguish parathyroid hormone excess from hypocalciuric forms of hypercalcemia, Real-time ultrasonography and dual-isotope subtraction scanning provide accurate, noninvasive, preoperative localization of abnormal parathyroid tissue. The prognosis of untreated, asymptomatic primary hyperparathyroidism in children is not known, and the indications for surgery are unclear. Diagnostic certainty is, therefore, especially important prior to surgical exploration. (AJDC 1986;140:819-821) References 1. Girard RM, Belanger A, Hazel B: Primary hyperparathyroidism in children . Can J Surg 1982;25:11-13. 2. Norwood S, Andrassy RJ: Primary hyperparathyroidism in children: A review . Milit Med 1983;148:812-814. 3. Arisaka O, Arisaka M, Toyono K, et al: Primary hyperparathyroidism . Clin Pediatr 1985;24:347-350.Crossref 4. Malek RS, Kelalis PP: Urologic manifestations of hyperparathyroidism in childhood . J Urol 1976;115:717-719. 5. Marx SJ: New insights into primary hyperparathyroidism . Hosp Pract Off , (March) 1984, pp 55-63. 6. Ghazali S, Barratt TM: Urinary excretion of calcium and magnesium in children . Arch Dis Child 1974;45:97.Crossref 7. Stapleton FB, Noe HN, Jerkins G, et al: Urinary excretion of calcium following an oral calcium loading test in healthy children . Pediatrics 1982;69:594-597. 8. Wallach J: Interpretation of Pediatric Tests . Boston, Little Brown & Co Inc, 1983, p 102. 9. Scholz DA, Purnell DC: Asymptomatic primary hyperparathyroidism: Ten-year prospective study . Mayo Clin Proc 1982;56:473-478. 10. Tsang RC, Venkataraman P: Pediatric parathyroid and vitamin D-related disorders , in Kaplan SA (ed): Clinical Pediatric and Adolescent Endocrinology . Philadelphia, WB Saunders Co, 1982, pp 346-366. 11. Gluckman PD, Ferguson RS, Osborne D, et al: Primary hyperparathyroidism in a child: Use of jugular venous catheterization in diagnosis . Arch Dis Child 1977;52:504-505.Crossref 12. Simeone JF, Mueller PR, Ferrucci JT, et al: High-resolution real-time sonography of the parathyroid . Radiology 1981;141:745-751.Crossref 13. Waldorf JC, van Heerden JA, Gorman CA, et al: Selenomethionine scanning for parathyroid localization should be abandoned . Mayo Clin Proc 1984;59:534-537.Crossref 14. Young AE, Gaunt JI, Croft DN, et al: Location of parathyroid adenomas by thallium-201 and technetium 99m subtraction scanning . Br Med J 1983;286:1384.Crossref 15. Marx SJ, Spiegel AM, Levine MA, et al: Familial hypocalciuric hypercalcemia: The relation to primary parathyroid hyperplasia . N Engl J Med 1982;307:416.Crossref 16. Aurbach GD, Marx SJ, Spiegel AM: Parathyroid hormone, calcitonin, and the calciferols , in Wilson JD, Foster DW (eds): Williams Textbook of Endocrinology . Philadelphia, WB Saunders Co, 1985, pp 1137-1217.
American Journal of Diseases of Children – American Medical Association
Published: Aug 1, 1986