Ayşe Derya BULUŞ, Elif YAĞLI, Uğur Ufuk IŞIN

Çocukluk Çağında Hiperkalseminin Nadir Bir Nedeni Paratiroid Adenomu

Hiperparatiroidizm çocukluk çağında çok nadir görülen bir hastalıktır. Genellikle bulantı, kusma, kabızlık, irritabilite, letarji, başağrısı, poliüri ve polidipsi gibi özgül olmayan semptomlarla başvurabilmekte ve bu nedenle tanı alması gecikebilmektedir. Tanı klinik inceleme ve laboratuvarbulguları ile konulur. Görüntüleme yöntemleri ile paratiroid hiperplazisi ve adenomu ayrımı yapılmaktadır.Paratiroid adenomunun kesin tedavisi adenomun çıkartılmasıdır. Burada acil servise ateş yakınması ile başvuran, hiperparatiroidiye bağlı hiperkalsemi tespit edilen ve paratiroid sintigrafisi ile tiroid lojunun sağ alt kesiminde tek paratiroid adenomu saptanan 7 yaşındaki kız hastayıtartışacağız.

Anahtar Kelimeler:

Çocukluk çağı, hiperkalsemi, paratiroid adenom

A Rare Cause of Childhood Hypercalcemia: Parathyroid Adenoma

Hyperparathyroidism is very rare disorder in childhood. Patients usually present with non-specific symptoms such as nausea, vomiting, constipation, irritability, lethargy, headache, polyuria and polydipsia, and the diagnosis can therefore be delayed. Diagnosis is made by clinical examinationand laboratory findings. Parathyroid hyperplasia and adenomas can be differentiated with imaging methods. Definitive treatment of a parathyroid adenoma is removal of the adenoma. We discuss a 7 year-old girl who had hypercalcemia due to hyperparathyroidism. She presented at our emergency department because of fever and was diagnosed with a solitary parathyroid adenoma locatedon the lower right side of the thyroid gland by using parathyroid sintigraphy.

Keywords:

Childhood, hypercalcemia, parathyroid adenoma,

PDF

___

1. Clerkin EP. Hyperparathyroidism. In: Cady B, Rossı RL (eds). Surgery of the Thyroid and Parathyroid Glands. 3rd ed. WB Saunders Company 1991; 243-53.
2. Bringhurst FR, Demay MB Kronenberg HM. Hormones and disorders of mineral metabolism. In: Wilson JD, Foster DW, Kronenberg HM, Larsen PR (eds). Williams Textbook of Endocrinology. 9th ed. WB Saunders Company 1998; 1155-209.
3. Habener J, Arnold A, Potts JT. Hyperparathyroidism. In: De Groot LJ (ed). Endocrinology. 3rd ed. WB Saunders Company 1995; 1044-66.
4. Bilezikian JP, Silverberg SJ. Primary hyperparathyroidism: Still evolving? Journal of Bone and Mineral Research 1997; 12: 856-62.
5. Kollars J, Zarroug AE, Heerden JV, Lteif A, Stavlo P, et al. Primary hyperparathyroidism in pediatric patients. Pediatrics 2005;115:974.
6. George J, Acharya SV, Bandgar TR, Menon PS, Shah NS. Primary hyperparathyroidism in children and adolescents. Indian J Pediatr 2010;77:175-8.
7. Lietman SA, Germain-Lee EL, Levine MA. Hypercalcemia in children and adolescents. Curr Opin Pediatr 2010;22:508-15.
8. Dijkstra B, Healy C, Kelly LM, Mcdermott EW, Hill ADK, et al. Parathyroid localisation-current practice. J R Coll Surg Edinb 2002:47:599-607.