Skip Navigation

This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (2)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Yumita, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Yumita, S.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Nephrol Dial Transplant (2003) 18: III62-III64
© 2003 European Renal Association-European Dialysis and Transplant Association

Original Article

Intervention for recurrent secondary hyperparathyroidism from a residual parathyroid gland

Shigeru Yumita

Department of Nephroendocrinology, Kojinkai Central Hospital, Sendai, Japan

There is a significant recurrence rate of secondary (renal) hyperparathyroidism after total parathyroidectomy (PTx) with forearm autograft. The lesions responsible for recurrent hyperparathyroidism are mainly the parathyroid autografts, but in some cases there are previously undetected residual or ectopic parathyroid glands. In Kojinkai hospitals, 155 haemodialysis out-patients had total PTx and forearm autograft for severe renal hyperparathyroidism and, during the past 18 years, 40 of them developed recurrent or persistent renal hyperparathyroidism. Five patients were treated by percutaneous ethanol injection therapy (PEIT): four patients had residual parathyroid glands and one patient had an ectopic parathyroid gland. The results of PEIT depended on the functioning of the parathyroid autografts. In two patients with non-functioning autografts, the effect of PEIT was remarkable; both showed ‘hungry bone’ syndrome and became hypoparathyroid. In the three patients with functioning autografts, the clinical course after PEIT was mild, but resection of the autograft was required in one patient. When an echo-guided approach is possible, PEIT for residual parathyroid glands is an effective intervention for the management of recurrent renal hyperparathyroidism; however, there is a risk of hypoparathyroidism in patients with non-functioning parathyroid autografts. As parathyroid autografts consist of multiple nodules, echo-guided injection of ethanol or calcitriol to each nodule is almost impossible and therefore resection of the autograft is indicated for autograft-dependent recurrent renal hyperparathyroidism.

Keywords: ectopic parathyroid gland; PEIT; persistent secondary hyperparathyroidism; recurrent secondary hyperparathyroidism; residual parathyroid gland

Correspondence and offprint requests to: Shigeru Yumita, Institute, Director, Department of Nephroendocrinology, Kojinkai Central Hospital, 2-1-6, Tsutsujigaoka, Miyagino-ku, Sendai 983-0852, Japan. Email: s_yumita{at}polka.plala.or.jp


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.