Primary hyperparathyroidism (PHPT) is a rare disorder in children, predominantly caused by parathyroid adenoma, often leading to delayed diagnosis and significant morbidity.

Subjects and Methods: A prospective analysis of children with PHPT secondary to parathyroid adenoma, study period from 2015 to 2024 at a single institution. Data evaluated included demographics, clinical manifestations, biochemical and radiological features, surgical interventions, and postoperative care.

Results: Six children (4 males, and 2 females) with a mean age of 13.8 years (range 7–17) were evaluated. The mean duration from symptom onset to diagnosis was 3 years. All children presented with musculoskeletal deformities and exhibited elevated serum calcium (mean 12.48 milligrams per deciliter (mg/dl)) and serum parathyroid hormone levels (1789–2500 picograms per milliliter (pg/mL)). Imaging with ultrasonogram and Isotope scan was successful in confirming the location of parathyroid adenoma with 100% sensitivity. Surgical excision was successful, and all patients developed hungry bone syndrome- clinically or biochemically, requiring calcium supplementation. The mean serum calcium at discharge was 8.68 mg/dL, with no recurrence noted during an average follow-up of 9 years.

Discussion: Pediatric PHPT necessitates a high index of suspicion for timely diagnosis and intervention to prevent development of permanent disabilities. Effective surgical management and postoperative care can significantly enhance patient outcomes.

Manasa is a Pediatric Surgeon trained at the Indira Gandhi Institute of Child Health (IGICH), Bengaluru, one of India’s premier centers for pediatric care and surgical training. She has developed expertise in the management of complex neonatal and pediatric surgical conditions, with clinical interests spanning gastrointestinal anomalies, pediatric abdominal emergencies, trauma, solid tumors and urology. Her practice is marked by precision, timely intervention, and a strong focus on perioperative care aimed at improving long-term outcomes in children. In addition to her clinical work, she is actively involved in academic and research contributions. She has published and presented case reports and articles on rare pediatric surgical conditions, including parathyroid adenoma in children and severe intra-abdominal injuries caused by animal bites. Through her academic work, she seeks to advance surgical knowledge and highlight the importance of early recognition and comprehensive management of unusual pediatric presentations. She also emphasizes public health education, particularly in the areas of injury prevention and awareness of surgical conditions in children. She advocates for family-centered care, ensuring that parents remain integral to the decision-making process. With her dedication to clinical excellence, research, and advocacy, She continues to make meaningful contributions to the field of pediatric surgery.