Int J Thyroidol.  2019 May;12(1):54-57. 10.11106/ijt.2019.12.1.54.

A Case Report: Total Parathyroidectomy with Autotransplantation for Secondary Hyperparathyroidism

Affiliations
  • 1Department of Otolaryngology, Inha University College of Medicine, Incheon, Korea. hopefuljw@gmail.com
  • 2Department of Endocrinology and Metabolism, Inha University College of Medicine, Incheon, Korea.
  • 3Department of Nephrology and Hypertension, Inha University College of Medicine, Incheon, Korea.

Abstract

Secondary hyperparathyroidism (HPT) usually result from parathyroid gland hyperplasia that produces excess parathyroid hormone (PTH). Decreased renal function leads to elevate serum phosphate levels and reduce vitamin D production, which results in hypocalcemia. Skeletal resistance to PTH results in persistently and frequently extremely elevated PTH levels and renal osteopathy. Treatment of choice for secondary HPT is medical management including calcitriol and vitamin D. However, for some cases in calciphylaxis and the failure including PTH >800 pg/mL or osteoporosis under maximal medical management surgical intervention could be an alternative option. We described a case of 47-year-old woman with surgical intervention for secondary hyperparathyroidism.

Keyword

Secondary hyperparathyroidism; Parathyroidectomy; Autotransplantation

MeSH Terms

Autografts*
Calciphylaxis
Calcitriol
Female
Humans
Hyperparathyroidism, Secondary*
Hyperplasia
Hypocalcemia
Middle Aged
Osteoporosis
Parathyroid Glands
Parathyroid Hormone
Parathyroidectomy*
Transplantation, Autologous*
Vitamin D
Calcitriol
Parathyroid Hormone
Vitamin D

Figure

  • Fig. 1 Parathyroid SPECT/CT (single-photon emission computed tomography/computed tomography) findings represent multiple increased MIBI (methoxyisobutyl-isonitrile) uptake (A), right superior (B), left inferior portion of thyroid gland (C).

  • Fig. 2 Round-shaped hyperplastic left inferior parathyroid in left level VI - paratracheal area (A), resected mass (B).


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