RENAL HYPERPARATHYROIDISM WITH CALCIFICATION OF THE ARTERIES IN INFANCY

Since Mandl's dramatic demonstration¹ that osteitis fibrosa can be relieved by the removal of a parathyroid adenoma, an extensive literature has appeared on hyperparathyroidism. The concept that in some cases hypertrophy of the parathyroid glands and osteitis fibrosa are secondary to chronic renal insufficiency is well established.² The close similarity between adult renal hyperparathyroidism and the renal rickets of late childhood and adolescence has been appreciated more recently.³ Both diseases are characterized by prolonged severe renal insufficiency, alterations in the calcium and phosphorus content of the blood and an increase in the urinary excretion of both substances, hypertrophy of the parathyroid glands, metastatic calcification and abnormalities in the bones. Renal rickets differs from adult renal hyperparathyroidism in the age at which it occurs, the fact that the renal insufficiency is usually due to a congenital anomaly and the greater variation in the appearance of the osseous lesions.