Abstract
Two cases of primary infantile hyperparathyroidism (PIH) are reported. In both cases the diagnosis was initially suspected from chest radiographs which were obtained to assess the etiology of fever and respiratory distress in one case and heart murmur in another. The first case responded well to subtotal parathyroidectomy. The second case had many unique features. (1) She never became overtly symptomatic. (2) She displayed a constellation of findings that are not yet emphasized. (3) Her indisputable radiographic findings of hyperparathyroidism vanished spontaneously by two months of age, whereas her biochemical alterations have persisted up to now, 21/2 years after birth. (4) Three members of her family have subclinical hyperparathyroidism (elevated serum parathormone, hypercalcemia, and hypophosphatemia).
Our review of 19 more cases showed that PIH has no specific clinical symptoms and/or signs. Of the laboratory findings, hypercalcemia was most consistantly encountered. The radiographic finding, although not identical to those described in hyperparathyroid adults, had the greatest diagnostic specificity. The disorder carried a grave prognosis if not diagnosed promptly and managed surgically.
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Anspach WE, Clifton WM (1939) Hyperparathyroidism in children. Am J Dis Child 58:540
Bradford WD, Wilson JW, Grade JT (1973) Primary neonatal hyperparathyroidism-An unusual cause of failure to thrive. Am J Clin Pathol 59:267
Corbeel L, Casaer P, Malvaux P, Lormans J, Bourgeois N (1968) Congenital hyperparathyroidism. Arch Fr Paediatr 25:879
DuBois R, Farriaux JP, Maillard E, Maillard JP (1968) Hyperparathyroidism primitif chez un nouveau-né. Ann Radiol (Paris) 12:407
Edeiken J (1981) Roentgen diagnosis of diseases of bone, 3rd edn. Williams and Wilkins, Baltimore London, p 879
Franklin RB, Tashjian AH Jr (1975) Intravenous infusion of prostaglandin E2 raises plasma calcium concentration in the rat. Endocrinology 97:240
Fretheim B, Gardborg O (1965) Primary hyperparathyroidism in an infant. Acta Chir Scand 129:557
Garcia-Bunuel R, Kutchemeshgi A, Brandes D (1974) Hereditary hyperparathyroidism. Arch Pathol 97:399
Goldbloom RB, Gillis DA, Prasad M (1972) Hereditary parathyroid hyperplasia: Surgical emergency of early infancy. Paediatrics 94:514
Hillman DA, Scriver CR, Pedvis S, Shragovitch I (1964) Neonatal familial primary hyperparathyroidism. N Engl J Med 270:483
Klein DC, Raisz LG (1970) Prostaglandins: Stimulation of bone resorption in tissue culture. Endocrinology 86:1436
Landon JF (1932) Parathyroidectomy in generalized osteitis fibrosa cystica. J Pediatr 1:544
Muhlethaler JP, Schärer K, Anterner I (1967) Akuter Hyperparathyreoidismus bei primärer Nebenschilddrüsenhyperplasie. Helv Pediatr Acta 22:529
Potts JT Jr (1977) Disorders of parathyroid glands. In: Thorn GW, Adams RD, Braunwald E, Isselbacher KJ, Petersdorf RG (eds) Harrison's principles of internal medicine, 8th edn. McGraw Hill Company, New York, p 2014
Philips RN (1948) Primary diffuse parathyroid hyperplasia in an infant of four months. Pediatrics 2:428
Pratt EL, Geren BB, Neuhauser EBD (1947) Hypercalcemia and idiopathic hyperplasia of the parathyroid glands in an infant. J Pediatr 30:388
Randall C, Lauchlan SC (1963) Parathyroid hyperplasia in an infant. Am J Dis Child 105:82
Rhone DP (1975) Primary neonatal hyperparathyroidism. Am J Clin Pathol 64:488
Schauberger CW, Pitkin RM (1979) Maternal perinatal calcium relationships. Obstet Gynecol 53:74
Seyberth HW, Segre GV, Morgan JL, Sweetman BJ, Potts JT, Oates JA (1975) Prostaglandins as mediators of hypercalcemia associated with certain types of cancer. N Engl J Med 293:1278
Siegler RL, Walker MB, Crouch RH, Christenson P, Jubiz W (1977) Plasma prostaglandin E concentrations from birth through childhood. J Pediatr 91:734
Spiegel AM, Harrison HE, Marx SJ, Brown EM, Aurbach GD (1977) Neonatal primary hyperparathyroidism with autosomal dominant inheritance. J Pediatr 90:269
Swischuk LE, Hayden CK Jr (1977) Seizures and demineralization of the skull. A diagnostic presentation of rickets. Pediatr Radiol 6:65
Thompson NW, Carpenter LC, Kessler DL, Nishimaya RH (1978) Hereditary neonatal hyperparathyroidism. Arch Surg 113:100
Whitby LG (1958) Intermittent hyperparathyroidism. Lancet 1:883
Woodhouse NJY, Doyle FH, Joplin GF (1971) Vitamin D deficiency+1° hyperparathyroidism. Lancet 2:283
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Eftekhari, F., Yousefzadeh, D.K. Primary infantile hyperparathyroidism: clinical, laboratory, and radiographic features in 21 cases. Skeletal Radiol 8, 201–208 (1982). https://doi.org/10.1007/BF00355507
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DOI: https://doi.org/10.1007/BF00355507