PMID- 24726110
OWN - NLM
STAT- MEDLINE
DCOM- 20141219
LR  - 20191210
IS  - 1531-5037 (Electronic)
IS  - 0022-3468 (Linking)
VI  - 49
IP  - 4
DP  - 2014 Apr
TI  - Preoperative multiple endocrine neoplasia type 1 diagnosis improves the surgical 
      outcomes of pediatric patients with primary hyperparathyroidism.
PG  - 546-50
LID - S0022-3468(13)00927-5 [pii]
LID - 10.1016/j.jpedsurg.2013.11.059 [doi]
AB  - BACKGROUND: Primary hyperparathyroidism (PHPT) is uncommon in children. The 
      surgical management of PHPT in children has evolved over the past two decades. 
      METHODS: A retrospective study of patients who underwent parathyroidectomy for 
      PHPT diagnosed at age < 18 years and managed at a tertiary referral center for 
      endocrine and familial disorders. RESULTS: Thirty-eight patients met eligibility 
      criteria (1981-2012). Median age at PHPT diagnosis was 15 years. Two-thirds of 
      patients were symptomatic (68%, n=26), most commonly from nephrolithiasis. 
      Twenty-six (68%) patients underwent a standard cervical exploration while 32% 
      underwent a focused unilateral parathyroidectomy. Multiple endocrine neoplasia 
      type 1 (MEN1) was diagnosed preoperatively in 22/26 patients. Patients with a 
      preoperative diagnosis of MEN1 were more likely to undergo a complete initial 
      operation (>/= 3 gland parathyroidectomy with transcervical thymectomy, 13/22, 59% 
      vs. 0/4, 0%; P=0.03) and less likely to have recurrent disease (10/22, 45% vs. 
      3/4, 75%; P<0.001) during follow up than patients diagnosed postoperatively. 
      CONCLUSIONS: Children with PHPT should raise suspicion for MEN1. Preoperative 
      MEN1 evaluation helped guide the extent of initial parathyroidectomy and was 
      associated with lower rates of recurrence in sporadic and familial PHPT in 
      pediatric patients. Management should occur at a high volume center with 
      experienced clinicians and genetic counseling services.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Romero Arenas, Minerva A
AU  - Romero Arenas MA
AD  - The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
FAU - Morris, Lilah F
AU  - Morris LF
AD  - The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
FAU - Rich, Thereasa A
AU  - Rich TA
AD  - The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
FAU - Cote, Gilbert J
AU  - Cote GJ
AD  - The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
FAU - Grubbs, Elizabeth G
AU  - Grubbs EG
AD  - The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
FAU - Waguespack, Steven G
AU  - Waguespack SG
AD  - The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
FAU - Perrier, Nancy D
AU  - Perrier ND
AD  - The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic 
      address: NPerrier@mdanderson.org.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20131127
PL  - United States
TA  - J Pediatr Surg
JT  - Journal of pediatric surgery
JID - 0052631
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hyperparathyroidism, Primary/etiology/*surgery
MH  - Male
MH  - Multiple Endocrine Neoplasia Type 1/complications/*diagnosis
MH  - Neoplasm Recurrence, Local
MH  - *Parathyroidectomy/methods
MH  - Retrospective Studies
MH  - Thymectomy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Children
OT  - Genetic testing
OT  - Hereditary disorders
OT  - Hypercalcemia
OT  - Multiple endocrine neoplasia
OT  - Primary hyperparathyroidism
EDAT- 2014/04/15 06:00
MHDA- 2014/12/20 06:00
CRDT- 2014/04/15 06:00
PHST- 2013/09/11 00:00 [received]
PHST- 2013/11/15 00:00 [revised]
PHST- 2013/11/19 00:00 [accepted]
PHST- 2014/04/15 06:00 [entrez]
PHST- 2014/04/15 06:00 [pubmed]
PHST- 2014/12/20 06:00 [medline]
AID - S0022-3468(13)00927-5 [pii]
AID - 10.1016/j.jpedsurg.2013.11.059 [doi]
PST - ppublish
SO  - J Pediatr Surg. 2014 Apr;49(4):546-50. doi: 10.1016/j.jpedsurg.2013.11.059. Epub 
      2013 Nov 27.