Tek Paratiroid Adenomuna Bağlı Hiperparatiroidizm: Olgu Sunumu

Yıl 2015, Cilt: 9 Sayı: 1, 51 - 54, 01.04.2015

Sinem Akbay Tunç Özdemir Kıvanç Çelikkalkan Şule Can Bumin Nuri Dündar

Öz

Hiperparatiroidizm çocukluk çağında çok nadir görülen bir hastalıktır. Genellikle bulantı, kusma, kabızlık, irritabilite, letarji, başağrısı, poliüri ve polidipsi gibi özgül olmayan semptomlarla başvurulmakta ve bu nedenle tanı konulması gecikebilmektedir. Tanı klinik inceleme ve laboratuvar bulguları ile konulur. Görüntüleme yöntemleri ile paratiroid hiperplazisi ve adenomu ayrımı yapılmaktadır. Hipokalsiürik hiperkalsemi ile karışabileceğinden idrar kalsiyum düzeylerine bakılması ayırıcı tanıda önemlidir. Paratiroid adenomunun kesin tedavisi adenomun çıkartılmasıdır. Ayrıca, kemik tutulumu ve uç organ hasarı yönünden dikkatli olunmalıdır. Burada, acil servise bulantı ve kusma yakınması ile başvuran, hiperparatiroidiye bağlı hiperkalsemi tespit edilen ve paratiroid sintigrafisi ile tiroid lojunun sağ alt kesiminde tek paratiroid adenomu saptanan 12 yaşındaki erkek olgu sunulmuştur.

Anahtar Kelimeler

Çocukluk çağı, Hiperkalsemi, Hiperparatiroidi, Paratiroid adenomu

Hyperparathyroidism due to a Parathyroid Adenoma: Case Report

Öz

Hyperparathyroidism is very rare disorder in childhood. Patients usually present with non-specifi c symptoms such as nausea, vomiting, constipation, irritability, lethargy, headache, polyuria and polydipsia, and the diagnosis can therefore be delayed. Diagnosis is made by clinical examination and laboratory fi ndings. Parathyroid hyperplasia and adenomas can be differentiated with imaging methods. Hypocalciuric hypercalcemia may have similar fi ndings and investigating urine calcium levels is important for the differential diagnosis. Defi nitive treatment of a parathyroid adenoma is removal of the adenoma. End organ damage such as bone changes and nephrocalcinosis should be kept in mind. We discuss a 12-year-old boy who had hypercalcemia due to hyperparathyroidism. He presented at our emergency department because of nausea and vomiting and was diagnosed with a solitary parathyroid adenoma located on the lower right side of the thyroid gland by using parathyroid scintigraphy

Anahtar Kelimeler

Childhood, Hypercalcemia, Hyperparathyroidism, Parathyroid adenoma

Kaynakça

• Kollars J, Zarroug AE, Heerden JV, Lteif A, Stavlo P, et al. Primary hyperparathyroidism in pediatric patients. Pediatrics 2005;115:974.
• George J, Acharya SV, Bandgar TR, Menon PS, Shah NS. Primary hyperparathyroidism in children and adolescents. Indian J Pediatr 2010;77:175-8.
• Lietman SA, Germain-Lee EL, Levine MA. Hypercalcemia in children and adolescents. Curr Opin Pediatr 2010;22:508-15.
• Simsek E, Arikan Y, Dallar Y, Akkus MA. Prolonged hungry bone syndrome in a 10-year-old child with parathyroid adenoma. Indian Pediatr 2009;46:178-80.
• Atabek ME, Pirgon O, Sert A, Esen HH. Extensive brown tumors caused by parathyroid adenoma in an adolescent patient. Eur J Pediatr 2008;167:117-9.
• Brachet C, Boros E, Tenoutasse S, Lissens W, Andry G, et al. Association of parathyroid adenoma and familial hypocalciuric hypercalcaemia in a teenager. Eur J Endocrinol 2009;161:207-10.
• Egan AM, Ryan J, Aziz MA, O’Dwyer TP, Byrne MM. Primary hyperparathyroidism in a patient with familial hypocalciuric hypercalcaemia due to a novel mutation in the calcium-sensing receptor gene. J Bone Miner Metab 2013;31:477-80.
• Li CC, Yang C, Wang S, Zhang J, Kong XR, et al. A 10-year retrospective study of primary hyperparathyroidism in children. Exp Clin Endocrinol Diabetes 2012;120:229-33.
• Benaderet AD, Burton AM, Clifton-Bligh R, Ashraf AP. Primary hyperparathyroidism with low intact pth levels in a 14-year-old girl. J Clin Endocrinol Metab 2011;96:2325-9.
• 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.