Primary Hyperparathyroidism Simulating Rickets

Lomnitz, Esteban; Sepúlveda, Luís; Stevenson, C; Barzelatto, J

doi:10.1210/jcem-26-3-309

Cited by 21 publications

(5 citation statements)

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“…There are only a few studies from developing countries that have correlated vitamin D levels with the clinical presentation and adenoma weight [98]. Because most of the patients are young (age range 34–54 years) in these series, delayed diagnosis of PHPT cannot explain the severe symptomatic PHPT seen in vitamin D‐deficient patients. Other strong evidence of vitamin D perpetuating the severity of PHPT comes from the reports of rickets coexisting with PHPT from India [99–101] and developed countries [102, 103] as well as the authors’ personal experience. In the series of Harinarayan et al [93], two patients had radiologic abnormalities suggestive of rickets. The prevalence of generalized bone pain in most series comes from developing countries.…”

Section: Issue 5: Is Calcium/vitamin D Deficiency Related To the Clin...mentioning

confidence: 99%

“…Other strong evidence of vitamin D perpetuating the severity of PHPT comes from the reports of rickets coexisting with PHPT from India [99–101] and developed countries [102, 103] as well as the authors’ personal experience. In the series of Harinarayan et al [93], two patients had radiologic abnormalities suggestive of rickets.…”

Section: Issue 5: Is Calcium/vitamin D Deficiency Related To the Clin...mentioning

confidence: 99%

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Hyperparathyroidism and Malnutrition with Severe Vitamin D Deficiency

2009

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Section: Issue 5: Is Calcium/vitamin D Deficiency Related To the Clin...mentioning

confidence: 99%

Section: Issue 5: Is Calcium/vitamin D Deficiency Related To the Clin...mentioning

confidence: 99%

Hyperparathyroidism and Malnutrition with Severe Vitamin D Deficiency

2009

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“… In pediatric and juvenile PHPT, there is more extensive and severe musculoskeletal involvement. Primary hyperparathyroidism may masquerade as rickets in children and adolescents which has earlier been reported in a few case reports [ 4 – 9 ]. In our cohort, 50% patients presented with rachitic manifestations with genu valgum being the most predominant phenomenon.…”

Section: Discussionmentioning

confidence: 97%

“…The literature on pediatric PHPT is so far limited to a few case reports and case series [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

The spectrum of manifestations of primary hyperparathyroidism in children and adolescents

Boro¹,

Khatiwada²,

Alam³

et al. 2022

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Introduction: Primary hyperparathyroidism (PHPT) is a rare disease in children and adolescents. Early recognition of this disease is important to prevent significant morbidity and mortality. Material and methods: We included 10 consecutive patients with PHPT aged 14 to 19 years of age and followed-up prospectively upto one year after parathyroidectomy. Results: Our cohort included 6 females and 4 males. The mean age of the patients was 16.7 ±1.8 years. The symptoms at presentation were musculoskeletal pain (90%), bone deformity (50%), fracture (30%), proximal myopathy (40%), renal stones (50%), reflux symptoms (40%), and pancreatitis (30%). The mean serum calcium was 3.1 ±0.5 mmol/l, mean serum inorganic phosphorus was 0.9 ±0.3 mmol/l and median serum alkaline phosphatase (ALP) was 1911.5 IU/l (IQR: 522.7-5702.3). The median serum intact parathyroid hormone was 133.5 pmol/l (IQR: 69.5 -178.7) while serum 25(OH)D was 47.7 nmol/l (IQR: 23.7-72.7). Hypercalciuria was observed in 7 patients. Hungry bone syndrome was observed in 4 (40%) patients after surgery. Typical parathyroid adenoma was found in 9 (90%) patients while one patient had atypical adenoma with high mitotic index. After one year of surgery, all patients had significant improvement in clinical and biochemical parameters with persistence of residual bone deformities. Conclusions: Our study showed the spectrum of manifestations of PHPT in children and adolescents and outcomes of parathyroidectomy till one year. Long-term follow-up studies with bigger cohorts are required to understand the true nature of the disease in children and adolescents.

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“…There are now several reports of patients with severe vitamin D deficiency, not attributable to other disease, complicating primary hyperparathyroidism (Lichtwitz et al, 1956;Lomnitz et al, 1966;Miravet et al, 1967;Vaishnava & Rizvir, 1969;Woodhouse et al, 1971;Stanbury, 1962Stanbury, , 1972. These patients had certain features in common: the serum calcium level was in the normal range or its rise was minimal when compared with the severity of their bone disease.…”

Section: Introductionmentioning

confidence: 99%