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[Tertiary hyperparathyroidism. Report of 5 cases]
V Pino Rivero1, G Pardo Romero, A González Palomino
1Facultativo Especialista de Otorrinolaringología, Complejo Universitario Infanta Cristina, Badajoz. vicentepinorivero@terra.com
Anales Otorrinolaringologicos Ibero-Americanos
|July 21, 2004
Summary
Tertiary hyperparathyroidism after kidney transplant is a persistent condition. Surgical intervention effectively normalized high calcium levels and improved bone issues in all reported patients.
Area of Science:
- Endocrinology
- Nephrology
- Surgical Pathology
Background:
- Tertiary hyperparathyroidism (THP) is characterized by autonomous parathyroid gland proliferation.
- THP can persist even after successful renal transplantation in patients with chronic kidney disease.
- This condition necessitates further management strategies beyond transplantation.
Observation:
- A case series of 5 patients (2 male, 3 female, ages 43-53) with THP post-renal transplant was observed over 14 years.
- Patients were referred for surgical intervention due to persistent hyperparathyroidism.
- Histopathology revealed parathyroid hyperplasia in 4 cases and an adenoma in 1 case.
Findings:
- Surgical treatment led to the normalization of hypercalcemia in all 5 patients.
- Two patients experienced transient hypocalcemia post-surgery.
- No recurrent laryngeal nerve palsies were reported.
Implications:
- Surgical management is a viable option for tertiary hyperparathyroidism refractory to renal transplantation.
- Parathyroidectomy can effectively resolve hypercalcemia and improve skeletal symptoms in these patients.
- This highlights the importance of considering surgical options for persistent endocrine complications post-transplant.