title: [Long-term effect after total parathyroidectomy with autotransplantation for secondary hyperparathyroidism].
abstract: 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.
authors.affiliation: Department of Urology, Kinki University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yamate
authors.forename: Y
authors.initials: Y
authors.lastname: Kato
authors.forename: H
authors.initials: H
authors.lastname: Kajikawa
authors.forename: Y
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: T
authors.initials: T
authors.lastname: Umekawa
authors.forename: N
authors.initials: N
authors.lastname: Amasaki
authors.forename: C
authors.initials: C
authors.lastname: Takamura
authors.forename: M
authors.initials: M
authors.lastname: Takada
authors.forename: K
authors.initials: K
authors.lastname: Kataoka
authors.forename: M
authors.initials: M
authors.lastname: Iguchi
authors.forename: T
authors.initials: T
authors.lastname: Kurita
mesh_terms: 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
chemical_list: D010281:Parathyroid Hormone; D000469:Alkaline Phosphatase