Journal of Indian Association of Pediatric Surgeons · 2025
Clinical Insights and Surgical Management of Pediatric Parathyroid Adenoma: Outcomes and Challenges.
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Manasa A, Shankar Gowri, Jadhav Vinay
Аннотация
INTRODUCTION: Primary hyperparathyroidism (PHPT) is a rare disorder in children, predominantly caused by parathyroid adenoma, often leading to delayed diagnosis and significant morbidity.
SUBJECTS AND METHODS: A prospective analysis of children with PHPT secondary to parathyroid adenoma, study period from 2015 to 2024 at a single institution. Data evaluated included demographics, clinical manifestations, biochemical and radiological features, surgical interventions, and postoperative care.
RESULTS: Six children (4 males, and 2 females) with a mean age of 13.8 years (range 7-17) were evaluated. The mean duration from symptom onset to diagnosis was 3 years. All children presented with musculoskeletal deformities and exhibited elevated serum calcium (mean 12.48 mg/dL) and serum parathyroid hormone levels (1789-2500 picograms per milliliter (pg/mL)). Imaging with ultrasonogram and Isotope scan was successful in confirming the location of parathyroid adenoma with 100% sensitivity. Surgical excision was successful, and all patients developed hungry bone syndrome, requiring calcium supplementation. The mean serum calcium at discharge was 8.68 mg/dL, with no recurrence noted during an average follow-up of 9 years.
DISCUSSION: Pediatric PHPT necessitates a high index of suspicion for timely diagnosis and intervention to prevent development of permanent disabilities. Effective surgical management and postoperative care can significantly enhance patient outcomes.
SUBJECTS AND METHODS: A prospective analysis of children with PHPT secondary to parathyroid adenoma, study period from 2015 to 2024 at a single institution. Data evaluated included demographics, clinical manifestations, biochemical and radiological features, surgical interventions, and postoperative care.
RESULTS: Six children (4 males, and 2 females) with a mean age of 13.8 years (range 7-17) were evaluated. The mean duration from symptom onset to diagnosis was 3 years. All children presented with musculoskeletal deformities and exhibited elevated serum calcium (mean 12.48 mg/dL) and serum parathyroid hormone levels (1789-2500 picograms per milliliter (pg/mL)). Imaging with ultrasonogram and Isotope scan was successful in confirming the location of parathyroid adenoma with 100% sensitivity. Surgical excision was successful, and all patients developed hungry bone syndrome, requiring calcium supplementation. The mean serum calcium at discharge was 8.68 mg/dL, with no recurrence noted during an average follow-up of 9 years.
DISCUSSION: Pediatric PHPT necessitates a high index of suspicion for timely diagnosis and intervention to prevent development of permanent disabilities. Effective surgical management and postoperative care can significantly enhance patient outcomes.