[Parathyroidectomy in children with renal failure. Retrospective study of 17 cases].
Parathyroidectomy (PTX) is rarely needed in children with end-stage renal disease and the new forms of vitamin D decrease its frequency. We report 17 cases of patients (14 with dialysis and 3 with functional renal graft) suffering from renal insufficiency in the pediatric age group who required a PTX. The surgical indications and techniques (partial PTX, total PTX with or without graft) varied with time and circumstances. After partial PTX, 3/10 patients were reoperated on. After PTX + graft one patient needed a second graft and another a graft curettage. Whatever the method, we noted normalization of clinical and radiological signs and a decrease in biological signs. The growth rate improved in most children during puberty, but outside of this period, no effect was noted. There is a definite indication for a PTX in cases with tertiary hyperparathyroidism. The indication seems questionable in cases with secondary hyperparathyroidism which can now be effectively treated with 1 alpha-hydroxylated forms of vitamin D. When necessary, total PTX with or without graft should be performed.
Service de Néphrologie pédiatrique, Hôpital des Enfants Malades, Paris.
E
E
Bérard
G
G
Crosca
M
M
Broyer
C
C
Fekete
M
M
Kenesi
M
M
Dechaux
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006128:Growth; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D010280:Parathyroid Glands / Q000473:pathology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies
Parathyroïdectomie chez l'enfant insuffisant rénal. Etude rétrospective de 17 observations.