Levard G, Gaudelus J, Cessans C
Service de Chirurgie Viscérale, CHU de Poitiers, Hôpital Jean-Bernard.
Ann Chir. 1992;46(7):653-8.
Primary hyperparathyroidism in children is an extremely rare condition. Slightly more than a hundred cases have been published in children or adolescents aged under 16. Forms with a neonatal presentation, the most rare, should be viewed apart since they rapidly become life-threatening. They involve hyperplasia of the chief cells of the parathyroid glands. Treatment is always surgical and should be rapid, consisting of total parathyroidectomy with autotransplantation. Primary hyperparathyroidism in older children more closely resembles that seen in adults. Sporadic forms are most often due to an adenoma and familial forms, which may occur alone or within the context of a polyendocrine syndrome, are most often due to hyperplasia. Treatment consists of parathyroidectomy, the extent of which depends upon the familial context, visual investigative findings and results of frozen section histology at the time of exploratory cervicotomy. Regardless of the age of the child, family investigation is always required to detect primary hyperparathyroidism occurring in the context of a hereditary disorder.
儿童原发性甲状旁腺功能亢进症极为罕见。16岁以下儿童或青少年中已发表的病例略多于100例。最罕见的新生儿表现形式应单独看待，因为它们会迅速危及生命。这些病例涉及甲状旁腺主细胞增生。治疗总是手术治疗，且应迅速进行，包括甲状旁腺全切术加自体移植。大龄儿童的原发性甲状旁腺功能亢进症与成人所见更为相似。散发型最常见的病因是腺瘤，而家族型可能单独出现或在多内分泌综合征的背景下出现，最常见的病因是增生。治疗包括甲状旁腺切除术，其范围取决于家族背景、影像学检查结果以及探查性子宫颈切开术时冰冻切片组织学检查结果。无论儿童年龄大小，始终需要进行家族调查以检测遗传性疾病背景下发生的原发性甲状旁腺功能亢进症。
