PEDIATRIC PRIMARY HYPERPARATHYROIDISM: A RARE CAUSE OF NEPHROLITHIASIS

Ana Teresa Soares, Miguel Fróis Borges, Margarida Pinto, Paulo Calhau, Maria Carlos Cordeiro, Isabel Nascimento, Manuela Braga

Abstract


Introduction: Primary hyperparathyroidism is a rare disease in the pediatric age group and a rare cause of nephrolithiasis. It results from an excessive production of the parathyroid hormone due to abnormalities within the parathyroid glands.

Case report: The patient was a twelve-year-old male admitted in the paediatrics emergency department with intermitent flank pain and dysuria. An abdominal ultrassound identified nephrolithiasis. Laboratorial tests showed hypercalcemia, an increased serum level of parathyroid hormone and hypercalciuria. A primary hyperparathyroidism was diagnosed and the ultrassound plus scintigraphy of both thyroid and parathyroid glands revealed a right lower parathyroid adenoma. A right lower parathyroidectomy was performed with regularization of the calcium and parathyroid hormone levels. The histopathology revealed main cells hyperplasia and genetic tests were negative.

Conclusion: Primary hyperparathyroidism should be considered in the differential diagnosis of nephrolithiasis to allow an early intervention and prevent organ damage.


Keywords


Children; hypercalcemia; Primary hyperparathyroidism; nephrolithiasis

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