Parathyroid Disorders

Pramod S Puligandla, MD, MSc, Nathan M Novotny, MD, Natalie Luehmann, MD, Robin Petroze, MD, Scott Langenburg, MD
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Parathyroid disorders in the pediatric population are rare. Hypoparathyroidism can result from congenital (e.g. DiGeorge syndrome) or acquired causes (e.g. postsurgical, tissue replacement by iron overloaded state and replacement by tumor). Hyperparathyroidism presents in the setting of primary, secondary, tertiary and pseudohyperparathyroidism as well parathyroid carcinoma, hyperparathyroidism-jaw tumor syndrome and neonatal severe primary hyperparathyroidism.

The most common manifestation of parathyroid disease is primary hyperparathyroidism. Possibly due to the uncommon occurrence of parathyroid disorders in children, the disease more often presents at an advanced stage with higher calcium levels. This has important clinical implications as severe hypercalcemia can be life threatening and swift identification and treatment, initially with medical management and then surgical intervention, is necessary.

The parathyroid glands were first noted in the Indian rhinoceros by Richard Owen in 1852 [1]. Parathyroid glands were discovered in humans by Ivar Snadstrom, a Swedish medical student, in 1880. Eugene Gley, a physiologist, documented the putative function of the glands in 1891 when he noted muscular tetani when removed. William G. MacCallum, in 1908, when investigating parathyroid tumors, proposed their role in calcium metabolism. The first successful gland removal was by Issac Olch in 1928 [2].

Parathyroid hormone (PTH) was first isolated by Adolph Hanson (1923) and James Collip (1925). Parathyroid hormone level studies by Roger Guillemin, Andrew Schally and Rosalyn Sussman Yalow led to the immunoassays capable of measuring PTH for which the Nobel Prize was given in 1977 [3].

content in this topic is referenced in SCORE Endocrine Diseases overview

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Last updated: November 19, 2018