Primary hyperparathyroidism in a 14-year-old female presenting with acute pancreatitis: case report and review of the literature

Abstract

Primary hyperparathyroidism (PHPT) is a rare condition in the pediatric population and is often diagnosed at an advanced stage due to delayed recognition. This delay can lead to significant complications, including metabolic disturbances and progressive skeletal deformities, such as genu valgum. Early identification is crucial to prevent severe outcomes associated with prolonged hypercalcemia. We report the case of a 14-year-old Palestinian Arab female who presented with acute pancreatitis 4 months after undergoing orthopedic surgery for genu valgum. Her medical history was notable for secondary amenorrhea over the preceding 3 months. Further evaluation revealed primary hyperparathyroidism. The patient underwent surgical removal of a parathyroid tumor (parathyroidectomy), after which her clinical condition improved significantly. To contextualize this case, a comprehensive literature review was conducted, identifying seven relevant articles comprising a total of nine pediatric cases. Across the reviewed cases, delayed diagnosis was consistently reported. All patients were treated with parathyroidectomy and demonstrated favorable outcomes. This case highlights the importance of early evaluation of unexplained skeletal deformities, specifically genu valgum in children and adolescents. Prompt assessment, including measurement of serum calcium levels, is essential to avoid delayed diagnosis and prevent serious complications of primary hyperparathyroidism. Early surgical intervention is associated with excellent outcomes in the pediatric population.