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Primary hyperparathyroidism in children and adolescents.
[familial hypocalciuric hypercalcemia]
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
.
Diseases
Validation
Diseases presenting
"failure to thrive"
symptom
22q11.2 deletion syndrome
alexander disease
child syndrome
congenital diaphragmatic hernia
cystinuria
familial hypocalciuric hypercalcemia
hirschsprung disease
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
krabbe disease
neonatal adrenoleukodystrophy
omenn syndrome
papillon-lefèvre syndrome
pyruvate dehydrogenase deficiency
triple a syndrome
wolf-hirschhorn syndrome
zellweger syndrome
This symptom has already been validated