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Hyperparathyroidism in children
Last reviewed: 23.04.2024
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Hyperparathyroidism - excess production of parathyroid hormone.
MKB-10 CODE
- E21.0 Primary hyperparathyroidism.
- E21.1 Secondary hyperparathyroidism, not elsewhere classified.
- E21.2 Other forms of hyperparathyroidism.
- E21.3 Hyperparathyroidism, unspecified.
Causes of hyperparathyroidism
Excess production of parathyroid hormone may be due to the primary pathology of parathyroid gland - adenoma or idiopathic hyperplasia (primary hyperparathyroidism). More often, however, in childhood, increased production of parathyroid hormone is compensatory, aimed at correcting hypocalcemia of one or another genesis (secondary hyperparathyroidism). Compensatory hyperparathyroidism is caused by rickets, malabsorption syndrome, hyperphosphatemia in chronic kidney diseases.
Symptoms of hyperparathyroidism in children
Hypercalcemia at any age, regardless of its cause, is manifested by muscle weakness, anorexia, nausea, vomiting, constipation, polydipsia, polyuria. Weight loss and fever. Calcium can be deposited in the kidney parenchyma (nephrocalcinosis). Kidney stones cause renal colic and hematuria. As a result of changes in the bones, pain in the back and limbs, gait disturbances, deformations, fractures and tumors are possible. Sometimes pain in the abdomen is noted.
Diagnosis of hyperparathyroidism
The most important laboratory-diagnostic signs: hypercalcemia (normal calcium content in the blood is 2.25-2.75 mmol / l, ionized fraction - 1.03-1.37 mmol / l), hypophosphatemia (less than 0.7 mmol / l), increased activity of alkaline phosphatase, hypercalciuria (more than 400 mg / day), an increase in the content of parathyroid hormone in the blood serum.
[8], [9], [10], [11], [12], [13], [14], [15]
Instrumental research
X-ray signs - cysts and giant cell tumors in long tubular and pelvic bones, diffuse osteoporosis. Pathognomonic sign is subperiosteal resorption of terminal phalanges of brushes and feet.
Nephrolithiasis and nephrocalcinosis are detected with ultrasound of the kidneys. For topical diagnosis of lesions of parathyroid glands, ultrasound, CT, MRI of the neck and mediastinum are informative.
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Treatment of hyperparathyroidism in children
Surgical, removal of adenomas.