[Long-term effect after total parathyroidectomy with autotransplantation for secondary hyperparathyroidism].
Although the short-term outcome of total parathyroidectomy combined with autotransplantation in cases of renal osteodystrophy has been reported by many investigators, few studies have been made on the long-term outcome of this surgical technique. We recently examined the long-term outcome of this surgery by following 19 cases for more than one year (range: 12-70 months, mean: 31.7 months). During the follow-up period, changes in subjective symptoms, biochemical parameters and bone mineral density (BMD) were monitored. At the end of the follow-up period, C-parathyroid hormone (C-PTH) and alkaliphosphatase (ALP) were significantly lower than their preoperative levels. Ca, P and %BMD showed no significant change from their preoperative levels, although %BMD tended to be higher than its preoperative level. Depending on the presence or absence of osteoarticular pain at the end of the follow-up period, the patients were divided into the improved group and the non-improved group. Of the 5 patients allocated to the non-improved group, 4 were female and only 1 was male. C-PTH and ALP were significantly higher in the non-improved group. %BMD was higher in the improved group than in the non-improved group, although this difference was not significant. In the non-improved group, 2 patients were suspected of having extra parathyroids, 1 was suspected of having recurrence, and 2 were suspected of having postoperative osteomalacia. Postoperative reduction in BMD was only seen in females, suggesting its relationship to postmenopausal osteoporosis.
Yamate
T
T
Department of Urology, Kinki University School of Medicine, Japan.
Kato
Y
Y
Kajikawa
H
H
Ishikawa
Y
Y
Umekawa
T
T
Amasaki
N
N
Takamura
C
C
Takada
M
M
Kataoka
K
K
Iguchi
M
M
Kurita
T
T
D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000637:transplantation*; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D010281:Parathyroid Hormone; D000469:Alkaline Phosphatase