Overview

Hyperparathyroidism is when the parathyroid glands make too much parathyroid hormone. The condition is rare in children.

The parathyroid glands are 4 tiny glands on the thyroid. The hormone they make helps manage levels of calcium in the bloodstream. High levels of the hormone lead to high levels of calcium. This occurs because the hormone causes bones to start breaking down. Minerals from the bone are released into the blood. This causes high levels of calcium in the blood. The calcium is then processed by the kidneys. This process can cause thinning bones (osteoporosis) and kidney stones. Kidney stones are hard mineral crystals that get stuck in the urinary system.

Causes

Causes can include:

  • Tumors on the parathyroid glands that aren’t cancer (benign)
  • Enlargement of the parathyroid glands
  • Vitamin D deficiency
  • Kidney failure

The condition in children is more often part of a syndrome, such as multiple endocrine neoplasia. 

Risk Factors

A child is at risk for if he or she has any of these:

  • Tumors on the parathyroid glands that aren’t cancer (benign)
  • Enlargement of the parathyroid glands
  • Multiple endocrine neoplasia

Symptoms

Symptoms can occur a bit differently in each child. They can include:

  • Kidney pain, from kidney stones
  • Bone pain, from thinning bones
  • Joint aches and pains
  • Belly (abdominal) pain
  • Nausea
  • Vomiting
  • Tiredness
  • Urinating a lot
  • Thirst
  • Confusion
  • Muscle weakness
  • Broken bones
  • Weight loss
  • Diarrhea
  • Constipation
  • Depression
  • Headache

The symptoms of hyperparathyroidism can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

Diagnosis

The condition can be hard to diagnose. The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam. Your child may also have tests, such as:

  • X-ray. This test uses a small amount of radiation to make images of tissues inside the body. An X-ray may be done of the bones to check for thinning.
  • Blood tests. These are done to measure calcium, phosphorus, magnesium, and hormone levels in the blood. The first sign of a parathyroid condition may be a higher than normal level on a calcium blood test.
  • Genetic testing. Your child may need this test if hyperparathyroidism or other related hormone conditions run in the family.
  • Ultrasound (sonography). This test uses sound waves and a computer to create images of blood vessels, tissues, and organs. This may be done to look at the parathyroid gland. 
  • Nuclear medicine test. This type of test uses small amounts of radioactive material to create images of the inside of the body. A test that adds radioactive material to a protein called sestamibi may be done. This can help to show the parathyroid glands.
  • CT scan. This test uses a series of X-rays and a computer to make detailed images of the body. A CT scan can show bones, muscles, fat, and organs. CT scans are more detailed than regular X-rays.
  • MRI. This test uses large magnets and a computer to make detailed images of tissues in the body.

Treatment

Your child's healthcare provider will consider his or her age, overall health, and other factors when advising treatment. Your child may need to see a pediatric endocrinologist. This is a doctor with extra training in treating children with hormone problems. Treatment usually includes surgery. This is done to remove some or all of the parathyroid glands.

Complications

If untreated, the condition can lead to serious complications including:

  • Thin bones (osteoporosis)
  • Broken bones
  • Other bone problems
  • Kidney stones
  • Kidney disease
  • Inflammation of the pancreas (pancreatitis)
  • High blood pressure
  • Heart problems including arrhythmias
  • Enlarged ventricles in the heart
  • Heart valve damage
  • Depression
  • Memory problems 

Living with

A child will need specialty care by a healthcare team. Even after surgery, a child may need life-long checking for symptoms of high calcium levels in the blood. Work with your child's healthcare providers to create an ongoing plan to manage your child’s condition.

When to Call a Healthcare Provider

Call your child’s healthcare provider if your child has symptoms of hyperparathyroidism. If your child has been diagnosed with the condition, call the healthcare provider if your child has:

  • Symptoms that don’t go away after treatment
  • Symptoms that come back after treatment
  • New symptoms

Key Points

  • Hyperparathyroidism is when the parathyroid glands make too much parathyroid hormone.    
  • The hormone helps manage levels of calcium in the bloodstream. High levels of the hormone lead to high levels of calcium.
  • The condition can cause thinning bones (osteoporosis) and kidney stones.
  • Symptoms can include bone pain, kidney pain, and joint aches.
  • Your child may have blood tests and imaging tests.
  • Treatment usually includes surgery. This is done to remove some or all of the parathyroid glands.
  • Even after surgery, a child may need life-long checking for symptoms of high calcium levels in the blood.

Next Steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.