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Newer Methods of Preoperative Diagnosis

David B. Allen, MD; Aaron L. Friedman, MD; S. Anne Hendricks, MD

Am J Dis Child. 1986;140(8):819-821.

Abstract
• An asymptomatic 11-year-old boy was found to have primary hyperparathyroid secondary to an isolated parathyroid adenoma. This rare disorder of childhood can have asymptomatic hypercalcemia as its only manifestation. Parathyroid hormone assays and studies of urinary calcium excretion, especially the calcium-creatlnine clearance ratio, distinguish parathyroid hormone excess from hypocalciuric forms of hypercalcemia, Real-time ultrasonography and dual-isotope subtraction scanning provide accurate, noninvasive, preoperative localization of abnormal parathyroid tissue. The prognosis of untreated, asymptomatic primary hyperparathyroidism in children is not known, and the indications for surgery are unclear. Diagnostic certainty is, therefore, especially important prior to surgical exploration.

(AJDC 1986;140:819-821)

Author Affiliations
From the Department of Pediatrics, University of Wisconsin Clinical Science Center, Madison.

Footnotes
Accepted for publication April 28, 1986.

Reprint requests to Department of Pediatrics, University Hospital and Clinics, 600 Highland Ave, H4/444, Madison, WI 53792 (Dr Allen).

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