# Three Malagasy Cases of Severe Bone Complications Revealing Primary Hyperparathyroidism

## TL;DR

This paper presents three rare cases of severe bone issues in young individuals caused by a hormone disorder called primary hyperparathyroidism.

## Contribution

The novelty lies in highlighting nonclassical pediatric PHPT cases with severe skeletal complications, emphasizing diagnostic challenges.

## Key findings

- Three young patients presented with severe bone deformities and fractures due to primary hyperparathyroidism.
- PHPT was diagnosed through hypercalcemia and elevated PTH levels in these rare pediatric cases.
- Nonclassical forms of PHPT can lead to significant disability if not promptly diagnosed.

## Abstract

Primary hyperparathyroidism (PHPT) is a metabolic disorder characterized by hypercalcemia with elevated or unsuppressed parathyroid hormone (PTH). It is rare in children but common in adults, particularly in women around the age of 50. In 85% of cases, PHPT is asymptomatic and is diagnosed following hypercalcemia and elevated PTH levels during routine examinations. PHPT occurring before the age of 25 and the normocalcemic phenotype are unusual situations that may delay diagnosis. These nonclassical forms expose patients to severe bone complications that can cause disability. Our objective is to report three clinical cases of PHPT revealed by catastrophic skeletal deformities and pathological fractures.