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Showing 2 results for Hyperparathyroidism
Evaluation of clinical manifestations and laboratory findings of primary hyperparathyroidism in Imam Hospital (1988-1998)
Nakhjavani M, Esteghamati A, Alam Salimi M,
Volume 60, Issue 6 (9-2002)
Abstract

Introduction: Clinical manifestations of primary hyper-para-thyroidism (pHPT) had been dramatically changed during last 25 years. Evaluation of changes in clinical findings was the aim of this study.

Materials and methods: In a retrospective, descriptive case series, patients' records of all 47 pHPT (44 females, 3 males) from 1988 till 1998 were studied. Patients’ clinical presentations, signs and symptoms, laboratory and radiologic findings were reviewed and the results were compared with 34 patients' studied during 1978-1987. Serum Ca>10.5 mg/dl with increased or high normal PTH were the diagnostic criteria of pHPT.

Results: Patients’ age range was 11-70 and mean ±SD was 38±16 years, with a female to male ratio of 14:1. 57 percent of the patients had bone pain and muscle weakness, 12 percent were asymptomatic, 10 percent had pathologic fractures, 8 percent had renal stones, 8 percent had symptoms of hypercalcemia, and 2 percent had giant cell lesion. The mean±SD of serum calcium was 11.48±1.16 mg/dl, phosphorus was 2.4±0.6 mg/dl and 24-h urinary Ca was 294±197 mg. Serum PTH was increased from 1.5 to 500 folds. The frequency of single adenoma in right inferior, left inferior, and left superior gland were 43 percent, 30 percent, and 13 percent respectively.

Conclusion: In the study 12 percent of patients were asymptomatic whereas there was no asymptomatic case in the previous study. Prevalence of severe bone disease and the interval between onset of symptoms and diagnosis was also reduced. According to this study detection of pHPT in asymptomatic phase remarkably increased.


The challenging management of hyperparathyroidism in a 9-year-old boy: a case report
Reza Tavakolizadeh , Abbas Alibakhshi, Sevil Abdolmohamadian ,
Volume 82, Issue 12 (3-2025)
Abstract
Background: Primary hyperparathyroidism is a rare but significant endocrine disorder in pediatric patients; although uncommon, parathyroid adenomas are the most frequently identified cause of primary hyperparathyroidism in this population. Diagnosis and treatment of primary hyperparathyroidism in children, especially in cases caused by parathyroid adenoma, demand careful assessment and require a coordinated and multidisciplinary approach involving endocrinologists, pediatric surgeons, radiologists, and other specialists. Early diagnosis is often delayed due to the rarity of the disease and the nonspecific nature of presenting symptoms.
Case Presentation: This case report describes the complex clinical management of a 9-year-old boy who presented with gradual onset of bone pain and visible deformities of the upper and lower extremities, which prompted further evaluation and later led to a diagnosis of hyperparathyroidism secondary to a parathyroid adenoma. The diagnosis was confirmed by elevated parathyroid hormone levels, hypercalcemia, and imaging studies revealing a parathyroid adenoma. Despite a comprehensive preoperative planning and surgical intervention, adenoma resection was not successful during the first two surgeries, leading to persistent hyperparathyroidism and subsequent surgical complications such as postoperative thyroid tissue damage and resultant iatrogenic hypothyroidism. Ultimately, the third surgical attempt successfully removed the adenoma, leading to a marked resolution of hyperparathyroidism and gradual return to normal calcium and parathyroid hormone levels. The patient’s bone pain and deformities showed improvement during follow-up.
Conclusion: This case highlights the numerous challenges in managing hyperparathyroidism in pediatric patients. In particular, it illustrates the potential complications that can arise when the disease is resistant to initial treatment efforts. This report underscores the importance of having a multidisciplinary approach, carefully planned and executed surgical intervention and vigilant postoperative care in pediatric patients with hyperparathyroidism. Early recognition, accurate localization of the adenoma, and coordination among specialists are essential for favorable outcomes in complex pediatric cases such as this. Continued follow-up is essential to monitor for recurrence and to manage any long-term complications.

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