Primary hyperparathyroidism in childhood

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Abstract


Primary hyperparathyroidism is a disease caused by excessive production of parathyroid hormone by the parathyroid glands. Most often, sporadic cases of the disease occur. In the family form of hyperparathyroidism, as well as in the syndrome of multiple endocrine neoplasia, the disease is caused by genetic changes. In manifest forms of the disease, hyperparathyroidism leads to destruction and deformation of bone tissue, osteoporosis, urolithiasis, cholelithiasis, pancreatitis, peptic ulcer disease, and disorders of mineral and electrolyte metabolism. Bone manifestations of the disease can lead to disability of the child. The article presents the experience of surgical treatment of 15 children, patients with primary hyperparathyroidism, aged from 6 to 18 years old, 10 of them girls and 5 boys operated in the period from 1973 to 2017. The main methods of diagnosis of the disease, the difficulties of timely diagnostic are discussed. The features of laboratory indicators of clinical manifestations of the disease are clearly shown. The clinical manifestations of primary hyperparathyroidism in children differed from adults more heavily damage of bone tissue with the development of gross deformities of the limbs. In 8 (57.3%) of 15 children, manifest forms of the disease were diagnosed. In 7 (46.7%) children, parathyroid adenomas were detected and removed during surgery for various thyroid diseases. In two patients, parathyroid adenomas were removed during operations performed for a genetically confirmed syndrome of multiple endocrine neoplasia of type IIa. In this study, the features of adenoma localization of the parathyroid gland, the possibility of surgical treatment and the dynamics of clinical manifestations after surgery are discussed. Proper treatment allowed to achieve full recovery.


Alexandr V. Gostimsky

Author for correspondence.
gostimsky@mail.ru
St. Petersburg State Pediatric Medical University
Russian Federation, St. Petersburg

MD, PhD, Dr Med Sci, Professor, Head, Department of General Medical Practice

Zoya S. Matveeva

ikar122@list.ru
St. Petersburg State Pediatric Medical University
Russian Federation, St. Petersburg

MD, PhD, Assistant Professor, Department of Hospital Surgery with Traumatology and Military Surgery Courses

Anatoliy F. Romanchishen

afromanchishen@mail.ru
St. Petersburg State Pediatric Medical University
Russian Federation, St. Petersburg

MD, PhD, Dr Med Sci, Professor, Head, Department of Hospital Surgery with Traumatology and Military Surgery Courses

Igor V. Karpatskiy

ivspb@mail333.com
St. Petersburg State Pediatric Medical University
Russian Federation, St. Petersburg

MD, PhD, Associate Professor, Department of General and Medical Chemistry

Sergey S. Peredereev

speredereev@yandex.ru
St. Petersburg State Pediatric Medical University
Russian Federation, St. Petersburg

Resident doctor, Surgical Department No 3

Oleg V. Lisovskiy

oleg.lisovsky@rambler.ru
St. Petersburg State Pediatric Medical University St. Petersburg

MD, PhD, Associate Professor, Department of General and Medical Chemistry

Victor V. Pogorelchuk

viktor-pogorelchuk@yandex.ru
St. Petersburg State Pediatric Medical University
Russian Federation, St. Petersburg

MD, PhD, Associate Professor, Department of General and Medical Chemistry

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Copyright (c) 2017 Gostimsky A.V., Matveeva Z.S., Romanchishen A.F., Karpatskiy I.V., Peredereev S.S., Lisovskiy O.V., Pogorelchuk V.V.

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