Highlights
- •Pediatric hyperparathyroidism is frequenyl sporadic.
- •5% of cases without family history ar attributed to genetic syndromes.
- •Sporadic HPT is due to single adenoma at a similar rate to sporadic adult population (85%).
- •Familila cases have higher recurrence rates with earlier onset, requiring close follow-up ad interventions are often needed.
Abstract
Background
Primary Hyperparathyroidism (PHPT) is rare in pediatric patients. Data regarding surgical
outcomes are scarce.
Methods
Single-center retrospective review (1994–2020) of patients ≤21 years undergoing surgery
for PHPT.
Results
66 patients were identified (61% female, 17 ± 3 years). 71% of patients were symptomatic
at diagnosis. 32% of patients had known familial syndromes, most commonly MEN-1. 23%
of patients without a known mutation had genetic testing, 22% positive. 56% of the
total and 19% of the familial cohort underwent focused exploration. Single gland disease
was found in 19% of familial vs 85% of sporadic cases, p < 0.00001. Persistence was 9%, all in the sporadic group, p = 0.11. Recurrence was
15%: 38% in the familial vs 2% in the sporadic groups, p=0.0004. Time to recurrence was 59 months (Q1-38, Q3-95), familial 61 vs 124 months
sporadic, p=0.001.
Conclusion
Pediatric PHPT is frequently sporadic, although 5% of apparent sporadic cases are
secondary to syndromes. Familial cases have higher rates of recurrence, requiring
closer follow-up.
Keywords
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Article info
Publication history
Published online: October 16, 2022
Accepted:
October 11,
2022
Received in revised form:
September 24,
2022
Received:
May 30,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
☆Poster presented the American Association of Endocrine Surgeons meeting in May 2022.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
