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Hyperparathyroidism in Children

What is hyperparathyroidism?

Hyperparathyroidism is caused by overactive parathyroid glands. Parathyroid glands are tiny glands located near the thyroid. Overactive parathyroid glands produce high levels of parathyroid hormone, which, in turn, results in increased levels of calcium in the bloodstream. The excess calcium released by the bones can lead to osteoporosis and osteomalacia (both bone-weakening diseases). Another result of hyperparathyroidism is kidney stones, because of high levels of calcium excreted into the urine by the kidneys. Hyperparathyroidism is quite rare in children.

What causes hyperparathyroidism?

Causes of hyperparathyroidism include benign (noncancerous) tumors on the parathyroid glands or enlargement of the parathyroid glands.

What are symptoms of hyperparathyroidism?

The following are the most common symptoms of hyperparathyroidism in children. However, each child may experience symptoms differently. Symptoms may include:

  • Kidney pain (due to the presence of kidney stones)

  • Diminished bone density that causes bone pain

  • Joint aches and pains

  • Abdominal pain

  • Nausea

  • Vomiting

  • Fatigue

  • Excessive urination

  • Confusion

  • Muscle weakness

  • Fractures

  • Weight loss

  • Diarrhea

  • Depression

  • Headache

Compared to adults, children more commonly have symptoms and involvement of other parts of the bodies, such as kidney, pancreas, and bones, at diagnosis. Additionally, hyperparathyroidism in children is more commonly part of a syndrome, such as multiple endocrine neoplasia. 

The symptoms of hyperparathyroidism may resemble other conditions or medical problems. Always consult your child's doctor for a diagnosis.

How is hyperparathyroidism diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for hyperparathyroidism may include:

  • Bone X-rays. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

  • Laboratory tests. The tests will measure calcium, phosphorus, magnesium, and hormone levels.

  • Ultrasonography. A procedure that evaluates the structure of the parathyroid gland using sound waves recorded on an electronic sensor. 

  • Nuclear medicine tests. These include Sestamibi and other scans that use small amounts of radioactive materials to evaluate how a parathyroid gland is functioning and to help diagnose problems. 

  • Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays. 

  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. 

How is hyperparathyroidism treated?

Specific treatment for hyperparathyroidism will be determined by your child's doctor in consultation with you.

Considerations include:

  • Your child's current health status and past health history

  • Severity of the condition

  • Your child's ability to take medications and tolerate medical procedures

  • Expectations for the course of the disease

  • Your beliefs and concerns

Treatment often includes removal of parathyroid tissue.

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