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Licensed Unlicensed Requires Authentication Published by De Gruyter October 6, 2016

Primary hyperparathyroidism may masquerade as rickets-osteomalacia in vitamin D replete children

  • Mohd Ashraf Ganie EMAIL logo , Nishant Raizada , Himika Chawla , Arun Kumar Singh , Sandeep Aggarwala and Chandra Sekhar Bal


Primary hyperparathyroidism, typically a disease of the middle aged and the old, is less commonly seen in children. In children the disease has a bimodal age distribution with calcium sensing receptor mutation presenting in infancy as hypercalcemic crises and parathyroid adenoma or hyperplasia presenting later in childhood with bone disease. The childhood parathyroid adenomas are often familial with multiglandular disease and manifest with severe bone disease unlike adults. We report a series of four male patients with juvenile primary hyperparathyroidism, three of whom presented with bone disease masquerading as rickets-osteomalacia. One patient had asymptomatic hypercalcemia with short stature. Parathyroid adenoma was detected in all the four cases and all of them underwent resection of parathyroid adenomas confirmed on histopathology. Post-surgery all the cases had initial hypocalcaemia followed by normocalcemia. One case developed pancreatitis after surgery even after achieving normocalcemia. We conclude that parathyroid adenomas, although uncommon in children, are an important cause of skeletal disease that may initially be confused with hypovitaminosis D.

Corresponding author: Dr. Mohd Ashraf Ganie, Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi-110029, India, Phone: +91-11-26593968, +91-9868856888

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


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Received: 2016-1-12
Accepted: 2016-7-18
Published Online: 2016-10-6
Published in Print: 2016-10-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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