ABSTRACT
In conditions of high calcium levels, normal parathyroid glands respond to a negative feedback loop by decreasing their production and release of PTH, resulting in low serum parathyroid hormone (PTH) levels. However, in primary hyperparathyroidism (HPT), there is elevated or inappropriately normal PTH production in the setting of high serum calcium levels. Similar to adults, in the pediatric and adolescent populations, symptoms of primary HPT are related to the severity and duration of hypercalcemia. Secondary HPT is a state of elevated PTH in the setting of low to normal serum calcium levels. Secondary HPT commonly occurs in patients with chronic renal failure. Tertiary HPT is rare in the pediatric population and occurs in the setting of prolonged parathyroid stimulation secondary to hypocalcemia, leading to parathyroid hyperplasia and subsequent autonomous PTH overproduction. The management of hyperparathyroidism in the pediatric population is largely extrapolated from adult guidelines.
