Madeira Isabel Rey, Machado Marise, Maya Maria Cristina A, Sztajnbok Flávio Roberto, Bordallo Maria Alice N
Setor de Endocrinologia Pediátrica, Unidade Docente Assistencial de Endocrinologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro.
Arq Bras Endocrinol Metabol. 2005 Apr;49(2):314-8. doi: 10.1590/s0004-27302005000200021. Epub 2005 Sep 12.
Primary hyperparathyroidism (PHP) is an uncommon disease in children and adolescents. The association between PHP and slipped capital femoral epiphysis is rare, and so far only four cases have been reported in the literature. Herein, we report a case of PHP due to a parathyroid adenoma, with several painful skeletal deformities and associated with slipped capital femoral epiphysis in an 18-year-old male patient. Laboratory evaluation showed: calcium of 13.6 mg/dL, parathyroid hormone of 1,524 pg/mL and alkaline phosphatase of 3,449 U/L. Deformities were caused by late diagnosis during the growth spurt, and this association is the result of combinations between metabolic and mechanical factors. The patient underwent parathyroidectomy and, in agreement with the literature, since the removal of the adenoma is followed by prompt resolution of the slipped capital femoral epiphysis we decided for a conservative approach. We observed improvement of the pain and normalization of calcium and parathyroid hormone levels.
原发性甲状旁腺功能亢进症（PHP）在儿童和青少年中是一种罕见疾病。PHP与股骨头骨骺滑脱之间的关联很罕见，迄今为止文献中仅报道过4例。在此，我们报告1例因甲状旁腺腺瘤导致的PHP病例，该18岁男性患者存在多处疼痛性骨骼畸形并伴有股骨头骨骺滑脱。实验室检查结果显示：血钙13.6mg/dL，甲状旁腺激素1524pg/mL，碱性磷酸酶3449U/L。畸形是由于生长突增期诊断延迟所致，这种关联是代谢因素和机械因素共同作用的结果。患者接受了甲状旁腺切除术，与文献一致，由于切除腺瘤后股骨头骨骺滑脱迅速缓解，我们决定采取保守治疗方法。我们观察到疼痛有所改善，血钙和甲状旁腺激素水平恢复正常。
