Manikandan u Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India
Meenakshi Sundari s Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India
Karuppasamy N Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India
Srinivasakumar R Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India
Aravindan C Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India
Selvakumar G. Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India
Address for correspondence: Manikandan u, Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India E-mail: drmanikandan.u@gmail.com
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Manikandan U, Sundari SM, Karuppasamy N, et al. Neonatal severe hyperparathyroidism: a case report. New Indian J Surg. 2023;14(3):193-197.
Timeline
Received : July 27, 2023
Accepted : September 01, 2023
Published : December 26, 2023
Abstract
Background: Neonatal severe hyperparathyroidism is an extremely rare condition that presents in the first few months of life. Recognition at the early stage followed by prompt surgical intervention are of vital importance for survival. Hypotonia, respiratory distress, lethargy and delay in growth and development occur in association with the elevated serum parathormone levels and hypercalcemia. Definitive therapy involves total parathyroidectomy. Case Description: We are presenting a case with Neonatal severe hyperparathyroidism, who underwent total parathyroidectomy. The patient had been followed up with medical therapy until. Parathormone levels rapidly declined following total parathyroidectomy and the patient was discharged with full recovery. Literature Review: Sestamibi scintigraphy might fail to show an ectopic parathyroid gland. In such conditions, on table confirmation of parathyroid glands by frozen section and Intra operative parathormone monitoring is vital at this point. Persistently elevated parathormone levels might suggest a remnant parathyroid tissue at the surgical site or an ectopic parathyroid gland that should be excised. Clinical Relavance: Neonatal severe hyperparathyroidism is a life-threatening disease. In the present case surgery performed at the early is life-saving due to the failure of medical therapy to control the disease.
References
1. Anthony W. Gannon, Heather M. Monk, Michael A. Levine, Cinacalcet monotherapy in neonatal severe hyperparathyroidism: a case study and review, J. Clin. Endocrinol. Metab. 99 (January (1)) (2014) 7–11, http://dx.doi. org/10.1210/jc.2013 2834.
2. R.A. Agha, M.R. Borrelli, R. Farwana, K. Koshy, A. Fowler, D.P. Orgill, For the SCARE Group, The SCARE 2018 statement: updating consensus surgical CAse REport (SCARE) guidelines, Int. J. Surg. 60 (2018) 132–136.
3. J. Tfelt-Hansen, E.M. Brown, The calcium sensing receptor in normal physiology and pathophysiology: a review, Crit. Rev. Clin. Lab. Sci. 42 (2005) 35–70.
4. G.N. Hendy, David E.C. Cole, Genetic defects associated with familial and sporadic hyperparathyroidism, Front. Horm. Res. 41 (2013) 149–165, http://dx.doi.org/10.1159/000345675, Epub 2013 Mar 19.
5. G.N. Hendy, L. D’Souza-Li, B. Yang, L. Canaff, D.E. Cole, Mutations of the calcium sensing receptor (CASR) in familial hypocalciuric hypercalcemia, neonatal severe hyperparathyroidism, and autosomal dominant hypocalcemia, Hum. Mutat. 16 (2000) 281–296.
6. Todd M. Brickman, Matthew W. Stark, Anita Jeyakumar, Unusual case of neonatal hypercalcemia, Int. J. Pediatr. Otorhinolaryngol. 79 (5) (2015) 758–759, http://dx.doi.org/10.1016/j. ijporl.2015.02.029.
7. J.C. Pallais, E.H. Kemp, C. Bergwitz, L. Kantham, D.M. Slovik, A.P. Weetman, E.M. Brown, Autoimmune hypocalciuric hypercalcemia unresponsive to glucocorticoid therapy in a patient with blocking autoantibodies against the calcium sensing receptor, J. Clin. Endocrinol. Metab. 96 (2011) 672–680.
8. S.J. Marx, D.M. Lourenc¸ o Jr., Familial hyperparathyroidism – disorders of growth and secretion in hormone-secretory tissue, Horm. Metab. Res. 49 (November (11)) (2017) 805–815, http://dx.doi.org/10.1055/s-0043-120670, Epub 2017 Nov 14.
10. N. Ahmed, Neonatal severe hyperparathyroidism secondary to an novel homozygous CASR gene mutation, Clin. Cases Miner. Bone Metab. 14 (3) (2017) 354–358.
9. S. Al-Shanafey, R. Al-Hosaini, A. Al-Ashwal, A. Al Rabeeah, Surgical management of severe neonatal hyperparathyroidism: one center’s experience, J. Pediatr. Surg. 45 (April (4))(2010) 714–717, http:// dx.doi.org/ 10.1016/j.jpedsurg.2009.08.005.
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Manikandan U, Sundari SM, Karuppasamy N, et al. Neonatal severe hyperparathyroidism: a case report. New Indian J Surg. 2023;14(3):193-197.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.