A case of normocalcemic variant of secondary hyperparathyroidism due to vitamin D deficiency

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The clinical manifestations of severe and/or prolonged vitamin D deficiency in adolescents differ from those in younger children. Vitamin D deficiency in adolescents may be asymptomatic or with nonspecific symptoms (pain in the joints, back, hips, difficulty walking, climbing stairs, rising from a squatting position, running, and muscle cramps), which reduce the quality of life. At the same time, teenagers with vitamin D deficiency are mistakenly diagnosed with fibromyalgia, chronic fatigue syndrome or depression. The article presents a clinical case of diagnosis and treatment of secondary hyperparathyroidism in a teenager due to vitamin D deficiency.

Full Text

Restricted Access

About the authors

N. Yu. Grishkevich

Prof. Voino-Yasenetsky Krasnoyarsk State Medical University

Author for correspondence.
Email: grishkevitch@mail.ru

Candidate of Medical Sciences

Russian Federation, Krasnoyarsk

E. P. Shitkovskaya

Prof. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: grishkevitch@mail.ru

Candidate of Medical Sciences

Russian Federation, Krasnoyarsk

S. V. Gladunova

Prof. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: grishkevitch@mail.ru
Russian Federation, Krasnoyarsk

References

  1. Мокрышева Н.Г., Еремкина А.К., Мирная С.С. и др. Трудности дифференциальной диагностики между первичной и вторичной формами гиперпаратиреоза. Ожирение и метаболизм. 2017; 14 (3): 48–53 [Mokrysheva N.G., Eremkina A.K., Mirnaya S.S. et al. Difficulties in differential diagnosis between primary and secondary forms of hyperparathyroidism. Obesity and Metabolism. 2017; 14 (3): 48–53 (in Russ.)]. doi: 10.14341/omet2017348-53
  2. Ильенкова Н.А., Климов Л.Я., Жекайте Е.К. и др. Обеспеченность витамином D детей с муковисцидозом в Российской Федерации в зимнее время года. Сибирское медицинское обозрение. 2019; 2: 29–36 [Ilyenkova N.A., Klimov L.Ya., Zhekaite E.K. et al. Vitamin D provision in children with cystic fibrosis in the Russian Federation in the winter season. Siberian Medical Review. 2019; 2: 29–36 (in Russ.)]. doi: 10.20333/2500136- 2019-2-29-3
  3. Crooks M., Bendall S. Parathyroid hormone and vitamin D: from bench to bedside. Orthopaedics and Trauma. 2021; 35 (5): 267–73. doi: 10.1016/j.mporth.2021.07.002
  4. Mahmoodzadeh H., Nasimfar A., Sadeghi E. et al. Study of Vitamin D Level in Children with Non-specific Musculoskeletal Pain. International Journal of Pediatrics. 2017; 5 (3): 4533–40. doi: 10.22038/ijp.2016.20988.1756
  5. Guo Y., Wang Q., Lu C. et al. New parathyroid function index for the differentiation of primary and secondary hyperparathyroidism: a case-control study. BMC Endocr Disord. 2020; 20 (1): 5. doi: 10.1186/s12902-019-0487-8
  6. Asghari G., Yuzbashian E., Wagner C.L. et al. The relation between circulating levels of vitamin D and parathyroid hormone in children and adolescents with overweight or obesity: Quest for a threshold. PLoS One. 2019; 14 (11): e0225717. doi: 10.1371/journal.pone.0225717
  7. Mace M.L., Olgaard K., Lewin E. New Aspects of the Kidney in the Regulation of Fibroblast Growth Factor 23 (FGF23) and Mineral Homeostasis. Int J Mol Sci. 2020; 21: 8810. doi: 10.3390/ijms21228810
  8. Pons-Belda O.D., Alonso-Álvarez MA., González-Rodriguez J.D. et al. Mineral Metabolism in Children: Interrelation between Vitamin D and FGF23. Int J Mol Sci. 2023; 24: 6661. doi: 10.3390/ijms24076661
  9. Yuen N.K., Ananthakrishnan S., Campbell M.J. Hyperparathyroidism of Renal Disease. Perm J. 2016; 20 (3): 15–127. doi: 10.7812/TPP/15-127
  10. Moralidis E. Radionuclide parathyroid imaging: a concise, updated review. Hell J Nucl Med. 2013; 16 (2): 125–33. doi: 10.1967/s002449910083
  11. López-Ramiro E., Rubert M., Mahillo I. et al. Secondary hyperparathyroidism due to vitamin D deficiency. Rev Osteoporos Metab Miner. 2016; 8 (2): 55–60. doi: 10.4321/S1889-836X2016000200002
  12. Malik M.Z., Latiwesh O.B., Nouh F. et al. Response of Parathyroid Hormone to Vitamin D Deficiency in Otherwise Healthy Individuals. Cureus. 2020; 12 (8): e9764. doi: 10.7759/cureus.9764
  13. Шулькина С.Г., Сирин Д.О., Смирнова Е.Н. и др. Проблемы дифференциальной диагностики вторичного гиперпаратиреоза. Пермский медицинский журнал. 2021; 38 (1): 161–7 [Shulkina S.G., Sirin D.O., Smirnova E.N. et al. Problems of differential diagnosis of secondary hyperparathyroidism. Perm Medical Journal. 2021; 38 (1): 161–7 (in Russ.)]. doi: 10.17816/pmj381161-167
  14. Смирнов В.В., Рылькова А.А. Гиперпаратиреоз в детском и подростковом возрасте. Лечащий врач. 2018; 12: 30–7 [Smirnov V.V., Rylkova A.A. Hyperparathyroidism in childhood and adolescence. Lechaschi Vrach. 2018; 12: 30–7 (in Russ.)].
  15. van der Plas W.Y., Noltes M.E., van Ginhoven T.M. Secondary and Tertiary Hyperparathyroidism: A Narrative Review. Scand J Surgery. 2020; 109 (4): 271–8. doi: 10.1177/1457496919866015
  16. Дедов Д.В., Иванов А.Г., Михайлова Е.А. и др. Профилактика дефицита кальция и витамина D при остеопорозе: возможность применения комбинированных препаратов Остеомед, Остеомед Форте, Остео-Вит-D3. Врач. 2023; 34 (3): 83–8 [Dedov D.V., Ivanov A.G., Mikhailova E.A. et al. Prophylaxis of calcium and vitamin D deficiency in osteoporosis: possibility of using combined preparations Osteomed, Osteomed Forte, Osteo-Vit-D3. Vrach. 2023; 34(3): 83–8 (in Russ.)]. doi: 10.29296/25877305-2023-03-18

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Multispiral computed tomography of the lower leg: in the upper third of the left tibia on the inner surface, the cortical layer is thickened up to 1.1 cm over 12 cm (hyperostosis)

Download (69KB)
Indexing metadata

Copyright (c) 2025 Russkiy Vrach Publishing House