Genu valgum and primary hyperparathyroidism in children

Abstract

Bony deformity due to primary hyperparathyroidism is a rare entity in children. Case Series: We describe two children who presented with genu valgum to the Endocrine Department. Ten children with primary hyperparathyroidism presenting with genu valgum have been reported in literature and have been reviewed by us. Biochemical investigations revealed parathyroid hormone dependent hypercalcemia despite a deficiency of vitamin D in both children. A single parathyroid adenoma was identified by ultrasonography and Tc-99m MIBI scan. Both children underwent resection of the solitary parathyroid lesion which was confirmed as adenoma by histopathological examination. All cases reported in literature had solitary parathyroid adenoma and had onset around puberty consistent with our observation that pubertal growth spurt is responsible for the occurrence of genu valgum in children with previously undiagnosed primary hyperparathyroidism. Genu valgum is a common skeletal deformity in children with primary hyperparathyroidism. Solitary parathyroid adenoma was identified in all reported cases and all underwent parathyroidectomy. Pubertal growth spurt seems to contribute to the occurrence of genu valgum in children with primary hyperparathyroidism.