Journal of Pediatric Biochemistry 2015; 05(03): 103-106
DOI: 10.1055/s-0036-1571833
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Persistent Elevation of Parathyroid Hormone during Pediatric Parathyroidectomy

Katherine W. Gonzalez
1   Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
,
Angela Ferguson
2   Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
,
Amy Wiebold
2   Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
,
Corey Iqbal
1   Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
,
Uttam Garg
2   Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
› Author Affiliations
Further Information

Publication History

05 June 2015

23 September 2015

Publication Date:
09 February 2016 (online)

Abstract

Primary hyperparathyroidism due to adenoma or hyperplasia is often the cause of inappropriately elevated parathyroid hormone in patients with hypercalcemia. Intraoperative monitoring of parathyroid hormone serum concentrations is widely accepted in the adult population, ensuring adequate resection during primary operative exploration. Here, we describe a pediatric case report during which intraoperative hormone monitoring was crucial in directing the operative approach. This symptomatic patient had standard preoperative studies. However, despite an adequate resection of the identified hyperactive tissue, her intraoperative parathyroid hormone concentrations remained inappropriately elevated prompting further dissection of neighboring tissue. A parathyroid adenoma was successfully excised during the operation, preventing further invasive procedures. This report highlights the feasibility of monitoring intraoperatively parathyroid hormone levels in the pediatric population.

 
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