Primary hyperparathyroidism in children and adolescents

Jeffrey Roizen, Michael A. Levine

Research output: Contribution to journalArticlepeer-review

Abstract

Primary hyperparathyroidism (PHPT) is a common endocrine disorder in adults in whom the typical presentation is incidentally discovered as asymptomatic hypercalcemia. PHPT is much less common in children and adolescents, but has greater morbidity in this age group, as most young patients with PHPT will have symptomatic hypercalcemia or complications such as kidney stones, abdominal pain, and skeletal fragility. An important feature of PHPT in younger patients is the relatively high prevalence of germline inactivating mutations of the CASR gene, which encodes the calcium-sensing receptor. Biallelic CASR mutations cause neonatal severe hyperparathyroidism, a life-threatening condition that presents within days of life with marked hypercalcemia, respiratory distress, failure to thrive, and skeletal demineralization. By contrast, more common heterozygous CASR mutations are generally associated with a benign variant of PHPT termed familial hypocalciuric hypercalcemia. Appropriate management of PHPT in children and adolescents requires distinction between familial hypocalciuric hypercalcemia, which generally requires no specific treatment, and other forms of PHPT that are best treated by parathyroidectomy.

Original languageEnglish (US)
Pages (from-to)425-434
Number of pages10
JournalJournal of the Chinese Medical Association
Volume75
Issue number9
DOIs
StatePublished - Sep 2012
Externally publishedYes

Keywords

  • Calcium sensing receptor
  • Hypercalcemia
  • MEN1
  • Osteoporosis
  • Parathyroid
  • Primary hyperparathyroidism
  • PTH

ASJC Scopus subject areas

  • Medicine(all)

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