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Mode de révélation inhabituel d’une hyperparathyroïdie primaire du sujet jeune: à propos de deux cas

Dhoha Ben Salah, Nabila Rekik, Lilia Affes, Mouna Elleuch, Fatma Mnif, Mouna Mnif, Mohamed Abid

Abstract


Primary hyperparathyroidism usually affects the elderly. Juvenile hyperparathyroidism is rare and poses specific diagnostic and therapeutic problems. We report the case of two young female patients, aged 14 and 19 years, with primary hyperparathyroidism detected due to femoral head involvement. One of those patients had slipped upper femoral epiphysis. Hyperparathyroidism only affected bone in both cases. No patient had a family history of this disease. Primary hyperparathyroidism was associated with solitary and benign parathyroid adenoma in both patients. They underwent complicated adenomectomy by persistent hypocalcaemia. This last was associated with hypoparathyroidism exacerbated by hungry bone syndrome, requiring substitutive vitaminocalcic therapy. It is well known that primary hyperparathyroidism rarely occurs in young subjects. Renal involvement is the most common clinical manifestation of hyperparathyroidism. Bone involvement and, in particular, slipped femoral epiphyses are an uncommon mode of revelation.

Keywords: Juvenile primary hyperparathyroidism, hypercalcemia, slipped upper femoral epiphysis



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