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Hyperparathyroidism in children

Alexey Kryvenko, medical expert
Last reviewed: 05.07.2025

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Hyperparathyroidism is an excess production of parathyroid hormone.

ICD-10 CODE

E21.0 Primary hyperparathyroidism.
E21.1 Secondary hyperparathyroidism, not elsewhere classified.
E21.2 Other forms of hyperparathyroidism.
E21.3 Hyperparathyroidism, unspecified.

Causes of hyperparathyroidism

Excessive production of parathyroid hormone may be caused by primary pathology of the parathyroid glands - adenoma or idiopathic hyperplasia (primary hyperparathyroidism). More often, however, in childhood, increased production of parathyroid hormone is compensatory, aimed at correcting hypocalcemia of one genesis or another (secondary hyperparathyroidism). Rickets, malabsorption syndrome, hyperphosphatemia in chronic kidney disease lead to compensatory hyperparathyroidism.

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Symptoms of hyperparathyroidism in children

Hypercalcemia at any age, regardless of its cause, is manifested by muscle weakness, anorexia, nausea, vomiting, constipation, polydipsia, polyuria, weight loss and increased body temperature. Calcium can be deposited in the renal parenchyma (nephrocalcinosis). Kidney stones cause renal colic and hematuria. As a result of changes in the bones, back and limb pain, gait disturbance, deformities, fractures and tumors are possible. Sometimes abdominal pain is noted.

Diagnosis of hyperparathyroidism

The most important laboratory diagnostic signs are: hypercalcemia (normal blood calcium content is 2.25-2.75 mmol/l, ionized fraction - 1.03-1.37 mmol/l), hypophosphatemia (less than 0.7 mmol/l), increased alkaline phosphatase activity, hypercalciuria (more than 400 mg/day), increased serum parathyroid hormone levels.

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Instrumental research

Radiographic signs include cysts and giant cell tumors in the long tubular and pelvic bones, diffuse osteoporosis. The pathognomonic sign is subperiosteal resorption of the terminal phalanges of the hands and feet.

Nephrolithiasis and nephrocalcinosis are detected by ultrasound of the kidneys. Ultrasound, CT, MRI of the neck and mediastinum are informative for topical diagnostics of parathyroid gland lesions.