Primary hyperparathyroidism (PHPT) is a common endocrine disorder in adults, typically presenting with incidental or asymptomatic hypercalcemia. It is usually diagnosed between the ages of 50 and 60 years, with an annual incidence of 30 cases per 100,000 patients, and lifetime prevalence of approximately 1 per 1000 persons. In adults, PHPT is more common among females, with an approximate ratio of 3:1 compared to males 1.

In contrast, PHPT occurs less frequently among children and adolescents, without apparent sex predominance and with estimated incidence of only 2–5 in 100,000 2–4. Unlike in adults, PHPT in children and adolescents is more often clinically symptomatic, with signs or symptoms of hypercalcemia, skeletal and renal complications such as bone pain, skeletal fragility, polyuria and/or nephrolithiasis5. These observations suggest that biological differences contribute to the distinct clinical presentation of PHPT between young and older patients.

Over the past 30 years, few large pediatric case series have been published increasing the number of reported cases of PHPT in this age group to several hundreds 6, 7, 8, 9, 10, 11, 12, 13, 14, 15. In the present study, we report our personal experience in the etiology, clinical presentation, management, treatment, and outcome of PHPT in children and adolescents.