This was not feasible in our patient. Primary parathyroid hyperplasia may be part of the multiple endocrine neoplasia. Therefore, this patient was screened for the other component of this syndrome. No evidence of this was demonstrated. In conclusion, hypercalcemia is an important phenomenon to be recognized and extensively worked up in childhood.
Primary hyperparathyroidism is a rare cause.
Surgical treatment is almost always indicated. Other associations and etiologies of this phenomenon should always be sought. We thank Prof. Salih for reviewing the manuscript. We also thank the Department of Pediatrics and Pediatric Surgery at King Khalid University Hospital, Riyadh for assistance in the workup of this case. Special thanks also go to Dr. El Desouki, head of Nuclear Medicine, for his helpful expertise.