Korean J Nephrol.
2011 Nov;30(6):671-675.
Maxillofacial Enlargement in Secondary Hyperparathyroidism Successfully Treated by Limited Parathyroidectomy and Paricalcitol
- Affiliations
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- 1Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Korea. yjkwon@korea.ac.kr
- 2Department of Radiology, Korea University College of Medicine, Korea University Medical Center, Korea.
- 3Department of Nuclear Medicine, Korea University College of Medicine, Korea University Medical Center, Korea.
- 4Division of Endocrine Surgery, Korea University College of Medicine, Korea University Medical Center, Korea.
- 5Department of Internal Medicine, Won-Kwang University College of Medicine, Korea.
- 6Department of Internal Medicine, Bupyung Serim General Hospital, Korea.
Abstract
- Maxillary enlargement is a rare complication of secondary hyperparathyroidism (SHPT). A 35-year-old Korean man undergoing chronic hemodialysis presented with a painless enlargement involving the maxilla and mandible. Plain radiography and CT scan showed bony expansion at the maxilla and mandible with multiple radiolucency. Serum intact parathyroid hormone (iPTH) was >1,600 pg/mL. Tc-99m sestamibi (MIBI) parathyroid scan and neck sonogram were compatible with SHPT. He underwent limited parathyroidectomy and commenced a course of paricalcitol. Fifteen months after surgery, maxillary enlargement and bony resorptions involving both hands markedly improved. Thirty-six months after the surgery, the serum iPTH level was 109.3 pg/mL. This is the first report in Korea documenting a patient with maxillary enlargement in SHPT who was successfully treated with limited parathyroidectomy and paricalcitol.
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