Combined radioguided parathyroidectomy and intravenous vitamin D therapy for the treatment of uraemic hyperparathyroidism.
Therapy combining radioguided parathyroidectomy (PTx) followed by intravenous maxacalcitol was given to a 50-year-old Japanese man referred for treatment of uraemic secondary hyperparathyroidism. After laboratory and radiological examinations, the patient underwent uncomplicated, successful surgery, but glands that had not been detected radiologically before the procedure became apparent with a scintillation counter immediately after the removal of the swollen gland. To prevent relapse of secondary hyperparathyroidism in the remaining glands, 10 microg of maxacalcitol was injected intravenously after each dialysis session. Following a minimally invasive radioisotope-guided PTx, the potential risk of relapse in the remaining glands has to be considered and intensive medical therapy should be instituted immediately after the operation. Further study needs to elucidate whether this treatment strategy can improve the long-term prognosis of patients with secondary hyperparathyroidism
Oyama
Yuko
Y
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata University Medical Hospital, Japan.
Kazama
J James
JJ
Maruyama
Hiroki
H
Narita
Ichiei
I
Kanbayashi
Chizuko
C
Koyama
Yu
Y
Omori
Tsukasa
T
Hatakeyama
Katsuyoshi
K
Gejyo
Fumitake
F
D002117:Calcitriol / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016105:Parathyroidectomy; D011182:Postoperative Care; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D025321:Surgery, Computer-Assisted; D017256:Technetium Tc 99m Sestamibi
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D002117:Calcitriol; C051883:maxacalcitol