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Persistent renal hyperparathyroidism caused by intrathyroidal parathyroid glands
Chin-Li Chen1, Shih-Hua Lin2, Jyh-Cherng Yu1
1Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Journal of the Chinese Medical Association : JCMA
|July 17, 2014
Summary
Intrathyroidal parathyroid glands can cause persistent renal hyperparathyroidism after surgery. Early detection using imaging is crucial for successful treatment in dialysis patients.
Area of Science:
- Endocrinology
- Nephrology
- Surgical Oncology
Background:
- Renal hyperparathyroidism is common in chronic renal failure patients undergoing dialysis.
- Persistent hyperparathyroidism after parathyroidectomy suggests ectopic or missed glands.
Observation:
- A 35-year-old woman on hemodialysis for 20 years presented with persistent renal hyperparathyroidism and symptoms of weakness and bone pain.
- Initial parathyroidectomy failed to resolve hyperparathyroidism, with no glands found on the left side.
Findings:
- Preoperative imaging (ultrasonography, SPECT/CT) localized ectopic intrathyroidal parathyroid glands.
- Surgical resection of these intrathyroidal glands led to patient recovery and symptom resolution.
Implications:
- Clinicians must consider intrathyroidal parathyroid glands in persistent renal hyperparathyroidism cases.
- Advanced imaging techniques are vital for localizing ectopic parathyroid tissue.
- Awareness of this uncommon condition improves diagnostic and therapeutic strategies for dialysis patients.
Keywords:
parathyroid glandssecondary hyperparathyroidismtechnetium-99m sestamibithyroidectomyultrasonographyMore Related Videos
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