CLINICAL AND LABORATORY DIAGNOSIS OF HORMONAL DISORDERS IN CHILDREN WITH PRIMARY HYPERPARATHYROIDISM COMPLICATED BY UROLITHIASIS

Abstract

Urolithiasis, a prevalent pathology affecting individuals of all age groups, has witnessed an alarming increase in incidence among children. Notably, primary hyperparathyroidism (PHPT) has emerged as a significant etiological factor, necessitating a deeper understanding of its impact on clinical manifestations and biochemical parameters in pediatric patients.

Methods: A retrospective study spanning 2009 to 2020 involved 52 children diagnosed with urolithiasis and PHPT. Clinical and biochemical analyses were conducted using specialized assays, including ionized calcium, parathyroid hormone (PTH), calcitonin, cyclic 3,5-adenosine monophosphate (cAMP), and vitamin D3. Statistical analysis employed the Fisher–Student method.

Results: Children with urolithiasis of PHPT origin exhibited distinct clinical symptoms, including adynamia, pain, and osteoarticular manifestations, differing significantly from the control group. Biochemically, elevated levels of ionized calcium, PTH, calcitonin, vitamin D3, and cAMP were observed, emphasizing hormonal dysregulation. Renal complications and sclerotic changes influenced the trajectory of biochemical markers, particularly in the second age group.

Conclusion: The clinical course of urolithiasis in children with PHPT is intricately linked to elevated levels of calcium and calcium-regulating hormones. Age-specific variations highlight the prolonged impact on growing organisms. Renal complications contribute to dynamic alterations in biochemical markers, necessitating a nuanced approach to diagnosis and intervention. This study underscores the need for early recognition and comprehensive management of urolithiasis in pediatric PHPT, paving the way for future research to refine diagnostic strategies and optimize therapeutic interventions.