Öz
Giriş
Hiperkalsemi çocuklarda yetişkinlere kıyasla daha nadir görülmekle birlikte, klinik olarak önemli bir durumdur.
Gereç ve Yöntem
Bu retrospektif çalışmada hiperkalsemi saptanan 0–18 yaş arası 21 hasta değerlendirildi. Klinik özellikler, laboratuvar bulguları ile klinik gerekliliğe göre yapılan görüntüleme ve genetik analizler incelendi. Hastalar hiperkalsemi şiddeti ve PTH durumuna göre sınıflandırılarak tedavi sonuçları kaydedildi.
Bulgular
Hastaların %33,3’ü asemptomatikti ve en sık başvuru şikâyeti kusmaydı (%19). Hastaların %66,7’sinde paratiroid hormonuna (PTH) bağımsız hiperkalsemi saptanırken, %33,3’ünde PTH’ye bağlı hiperkalsemi mevcuttu. Saptanan etiyolojiler arasında beş hastada paratiroid adenom, dört hastada adrenal yetmezlik, üç hastada D vitamini intoksikasyonu, üç hastada malignite, birer hastada osteomiyelit, psödohipoaldosteronizm, CaSR varyantı ve hipofosfatazya yer almaktadır. PTH’ye bağlı hiperkalsemisi olan yedi hastadan dördü cerrahi tedavi almıştır.
Sonuç
Bu çalışma, çocukluk çağı hiperkalsemisinin çok çeşitli nedenlere bağlı olarak gelişebileceğini ortaya koymaktadır. Belirsiz veya spesifik olmayan klinik bulgularla başvuran çocuklarda serum kalsiyum düzeylerinin ölçülmesi büyük önem taşımaktadır. Ek bulguların yokluğunda malignite tanısı gecikebilir. Erken tanı ve uygun müdahale, ciddi komplikasyonların önlenmesine katkı sağlayabilir.
Anahtar Kelimeler: Etiyoloji, hiperkalsemi, malignite, paratiroid hormon, pediatrik
Kaynakça
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