青少年原发性甲状旁腺功能亢进症：与成人原发性甲状旁腺功能亢进症的比较。
PRIMARY HYPERPARATHYROIDISM IN THE YOUNG: COMPARISON WITH ADULT PRIMARY HYPERPARATHYROIDISM.
出版信息
Endocr Pract. 2018 Dec;24(12):1051-1056. doi: 10.4158/EP-2018-0268. Epub 2018 Oct 5.
OBJECTIVE
Primary hyperparathyroidism (PHPT) is relatively common among adults but rarely encountered in children and adolescents. According to the western literature, young PHPT is different from adult PHPT and is associated with more severe hypercalcemia. PHPT in the adult Indian population is different from its western counterpart. Here we present the clinical, biochemical, and surgical characteristics of young patients with PHPT treated at our tertiary care center.
METHODS
PHPT patients were divided into adult (≥25 years) and young (<25 years) groups. The clinical, biochemical, hormonal, and histopathologic characteristics and treatment outcomes in the groups were compared.
RESULTS
Out of 358 patients, 47 patients were young and 311 patients were adults. The mean ages of the groups were 19 ± 4 and 45 ± 12 years, respectively. The corresponding female-to-male ratios were 1.24:1 and 3.38:1 ( P<.05). The nature and frequency of presenting symptoms were comparable between the 2 groups. The most common symptom in young patients with PHPT was bone pain and was not significantly different from adults (57% vs. 61%, respectively). The most common symptom in adult PHPT was fatigue, which was also not significantly different from young patients (63% vs. 53%, respectively), The serum calcium, phosphate, 25-hydroxyvitamin D levels; alkaline phosphatase Z-score; and parathyroid hormone levels were comparable between the 2 groups. Parathyroid adenoma was the most common histopathologic finding, while hyperplasia was rare in both groups.
CONCLUSION
We observed that young PHPT is not markedly different from its adult counterpart in an Indian population.
ABBREVIATIONS
ALP = alkaline phosphatase; Ca = calcium; Cr = creatinine; iPTH = intact parathyroid hormone; 25(OH)D = 25-hydroxyvitamin D; P = phosphate; PHPT = primary hyperparathyroidism; PTH = parathyroid hormone; RR = reference range; Tc sestamibi = technetium sestamibi; USG = ultrasonography.
目的
原发性甲状旁腺功能亢进症（PHPT）在成年人中较为常见，但在儿童和青少年中很少见。根据西方文献，年轻的 PHPT 与成年 PHPT 不同，且与更严重的高钙血症相关。印度成年人群中的 PHPT 与西方人群中的 PHPT 不同。在此，我们介绍在我们的三级护理中心接受治疗的年轻 PHPT 患者的临床、生化和手术特征。
方法
将 PHPT 患者分为成年（≥25 岁）和年轻（＜25 岁）两组。比较两组患者的临床、生化、激素和组织病理学特征及治疗结果。
结果
在 358 例患者中，47 例为年轻患者，311 例为成年患者。两组的平均年龄分别为 19 ± 4 岁和 45 ± 12 岁。相应的男女比例分别为 1.24:1 和 3.38:1（P＜0.05）。两组的症状性质和频率相似。年轻 PHPT 患者最常见的症状是骨痛，与成年患者无显著差异（分别为 57%和 61%）。成年 PHPT 患者最常见的症状是疲劳，与年轻患者也无显著差异（分别为 63%和 53%）。两组的血清钙、磷、25-羟维生素 D 水平、碱性磷酸酶 Z 评分和甲状旁腺激素水平相似。组织病理学检查最常见的发现是甲状旁腺腺瘤，而增生在两组中均很少见。
结论
在印度人群中，我们观察到年轻 PHPT 与成年 PHPT 无明显差异。
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