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Hiperparatiroidismo primário em idade pediátrica: uma causa rara de litíase renal
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Abstract(s)
Introdução: O hiperparatiroidismo primário é uma doença rara na idade pediátrica e define-se como uma alteração primá-ria das glândulas paratiroideias, que condiciona uma produção excessiva de hormona paratiroideia. Caso Clínico: Adolescente do sexo masculino com doze anos de idade admitido na Urgência pediátrica por lombalgia tipo cólica e disúria. A ecografia renal evidenciou litíase renal. A investigação laboratorial realizada revelou hipercalcémia, ele-vação sérica da hormona paratiroideia e hipercalciúria. Estabe-lecido o diagnóstico de hiperparatiroidismo primário, realizou ecografia cervical e cintigrafia das glândulas tiroideias e para-tiroideias que foi sugestiva de adenoma da paratiroideia infe-rior direita. Submetido a paratiroidectomia inferior direita com normalização dos valores da calcémia e da hormona paratiroi-deia pós-cirurgia. O exame histológico revelou hiperplasia das células principais. O estudo genético realizado foi negativo.Conclusão: O hiperparatiroidismo primário deve ser con-siderado no diagnóstico diferencial de litíase renal, de forma a permitir uma intervenção precoce determinante na prevenção de lesão de órgão-alvo.
Introduction: Primary hyperparathyroidism is a rare disease in the pediatric age group and a rare cause of nephrolithiasis. It results from an excessive production of the parathyroid hormone due to abnormalities within the parathyroid glands.Case report: The patient was a twelve-year-old male admitted in the paediatrics emergency department with intermitent flank pain and dysuria. An abdominal ultrassound identified nephrolithiasis. Laboratorial tests showed hypercalcemia, an increased serum level of parathyroid hormone and hypercalciuria. A primary hyperparathyroidism was diagnosed and the ultrassound plus scintigraphy of both thyroid and parathyroid glands revealed a right lower parathyroid adenoma. A right lower parathyroidectomy was performed with regularization of the calcium and parathyroid hormone levels. The histopathology revealed main cells hyperplasia and genetic tests were negative.Conclusion: Primary hyperparathyroidism should be considered in the differential diagnosis of nephrolithiasis to allow an early intervention and prevent organ damage.
Introduction: Primary hyperparathyroidism is a rare disease in the pediatric age group and a rare cause of nephrolithiasis. It results from an excessive production of the parathyroid hormone due to abnormalities within the parathyroid glands.Case report: The patient was a twelve-year-old male admitted in the paediatrics emergency department with intermitent flank pain and dysuria. An abdominal ultrassound identified nephrolithiasis. Laboratorial tests showed hypercalcemia, an increased serum level of parathyroid hormone and hypercalciuria. A primary hyperparathyroidism was diagnosed and the ultrassound plus scintigraphy of both thyroid and parathyroid glands revealed a right lower parathyroid adenoma. A right lower parathyroidectomy was performed with regularization of the calcium and parathyroid hormone levels. The histopathology revealed main cells hyperplasia and genetic tests were negative.Conclusion: Primary hyperparathyroidism should be considered in the differential diagnosis of nephrolithiasis to allow an early intervention and prevent organ damage.
Description
Keywords
criança hipercalcémia hiperparatirodismo primário itíase renal
Citation
Nascer e Crescer – Birth and Growth Medical Journal 2017; 26(2): 122-5
Publisher
Centro Hospitalar do Porto