Tertiary hyperparathyroidism treated by ultrasonically guided percutaneous fine-needle ethanol injection.
Advanced renal failure is often accompanied by secondary and tertiary hyperparathyroidism. In tertiary hyperparathyroidism it is necessary to reduce the gland mass. The present study describes the response to treatment with percutanous injection of ethanol of enlarged parathyroid nodules in 9 uremic patients. All had hypercalcemia, severely elevated serum levels of parathyroid hormone and ultrasonically detectable enlarged parathyroid glands. Three patients did not respond to the treatment. In the remaining 6 patients, serum values of total and ionized calcium were normalized and the serum values of parathyroid hormone were reduced at least 30% after 18 months. Seven of the patients experienced an improvement of symptoms. No complications were seen. We conclude that treatment with ethanol injection can be used as an alternative to conventional parathyroidectomy to improve parathyroid status in selected patients.
Department of Nephrology, Herlev County Hospital, Denmark.
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Cintin
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Karstrup
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Ladefoged
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P
Joffe
D000328:Adult; D000368:Aged; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy / Q000209:etiology; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D007267:Injections / Q000379:methods; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000187:drug effects; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000379:methods; D014463:Ultrasonography; D014511:Uremia / Q000150:complications
D010281:Parathyroid Hormone; D000431:Ethanol