title: Combined radioguided parathyroidectomy and intravenous vitamin D therapy for the treatment of uraemic hyperparathyroidism.
abstract: 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
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata University Medical Hospital, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Oyama
authors.forename: J James
authors.initials: JJ
authors.lastname: Kazama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Maruyama
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
authors.forename: Chizuko
authors.initials: C
authors.lastname: Kanbayashi
authors.forename: Yu
authors.initials: Y
authors.lastname: Koyama
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Omori
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
authors.forename: Fumitake
authors.initials: F
authors.lastname: Gejyo
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D002117:Calcitriol; C051883:maxacalcitol