Parathyroid adenoma causing hypercalcemic crisis masquerading as acute abdomen in a 7-year-old: a case report
Abstract
Background: Hypercalcemic crisis from a functioning parathyroid adenoma (PA) is exceptionally rare in prepubertal children and typically presents with a non-specific complaint such as polyuria or lethargy. We report a 7-year-old girl who was urgently referred for acute, colicky abdominal pain and repeated vomiting, which clinically mimicked acute appendicitis. During the work-up, extensive metabolic tests incidentally revealed severe hypercalcemia and elevated intact parathyroid hormone (PTH), which led to the diagnosis of PA-induced hypercalcemic crisis.Her initial manifestation was an acute abdomen rather than renal or neuropsychiatric symptoms. The case underscores that functioning PA should be included in the differential diagnosis of children presenting with unexplained gastrointestinal distress, and illustrates that timely diagnosis and focused parathyroidectomy can effectively reverse biochemical abnormalities, alleviate skeletal symptoms, and mitigate the risk of serious long-term complications.
Case presentation: We report the case of a seven-year-old female patient who was hospitalized due to complaints of abdominal discomfort accompanied by episodes of recurrent vomiting.Subsequent analysis revealed that these symptoms may represent acute gastrointestinal syndrome in the context of a hypercalcemic crisis.We describe her clinical course, diagnostic workup, and treatment. Laboratory tests revealed severe hypercalcemia (4.67 mmol/L; reference range: 2.1-2.7mmol/L),…
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