Pitfalls after total parathyroidectomy and parathyroid allotransplantation in chronic renal failure

Laurence R.I. Baker; Leander S. Otieno; Alison L. Brown; Melvyn J. Carroll; William R. Cattell; Ken Farrington

doi:10.1159/000168301

Pitfalls after total parathyroidectomy and parathyroid allotransplantation in chronic renal failure

Laurence R.I. Baker, Leander S. Otieno, Alison L. Brown, Melvyn J. Carroll, William R. Cattell, Ken Farrington

Research output: Contribution to journal › Article › peer-review

15 Citations (Scopus)

Abstract

We have described 4 patients with chronic renal failure receiving regular hacmodialysis treatment who underwent total parathyroidectomy with autotransplantalion of parathyroid fragments into the forearm musculature for hypercalcacmic hyperparathyroidism. In all. there was an immediate and profound fall in plasma calcium levels. Hypercalcaemia recurred 1-5 years post-operatively and was resistant to resection of the autograft. In 3 cases, lhallium-lechnetium subtraction scanning and multiple venous sampling for estimation of parathyroid hormone levels suggested multiple sites of hypersecretion of parathyroid hormone in the neck. In I case, these investigations revealed a mediastinal adenoma which was successfully removed. These cases reinforce previous suggestions that total parathyroidectomy is frequently incomplete and undermine the procedure of total parathyroidectomy with autotransplantation in patients with persisting uraemia.

Original language	English
Pages (from-to)	185-191
Number of pages	7
Journal	American Journal of Nephrology
Volume	11
Issue number	3
DOIs	https://doi.org/10.1159/000168301
Publication status	Published - 1991
Externally published	Yes

Keywords

Chronic renal failure
Haemodialysis
Hypercalcaemia
Hyperparathyroidism
Thallium-technetium subtraction scan
Total parathyroidectomy with autotransplantation

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10.1159/000168301

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title = "Pitfalls after total parathyroidectomy and parathyroid allotransplantation in chronic renal failure",

abstract = "We have described 4 patients with chronic renal failure receiving regular hacmodialysis treatment who underwent total parathyroidectomy with autotransplantalion of parathyroid fragments into the forearm musculature for hypercalcacmic hyperparathyroidism. In all. there was an immediate and profound fall in plasma calcium levels. Hypercalcaemia recurred 1-5 years post-operatively and was resistant to resection of the autograft. In 3 cases, lhallium-lechnetium subtraction scanning and multiple venous sampling for estimation of parathyroid hormone levels suggested multiple sites of hypersecretion of parathyroid hormone in the neck. In I case, these investigations revealed a mediastinal adenoma which was successfully removed. These cases reinforce previous suggestions that total parathyroidectomy is frequently incomplete and undermine the procedure of total parathyroidectomy with autotransplantation in patients with persisting uraemia.",

keywords = "Chronic renal failure, Haemodialysis, Hypercalcaemia, Hyperparathyroidism, Thallium-technetium subtraction scan, Total parathyroidectomy with autotransplantation",

author = "Baker, {Laurence R.I.} and Otieno, {Leander S.} and Brown, {Alison L.} and Carroll, {Melvyn J.} and Cattell, {William R.} and Ken Farrington",

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AU - Baker, Laurence R.I.

AU - Otieno, Leander S.

AU - Brown, Alison L.

AU - Carroll, Melvyn J.

AU - Cattell, William R.

AU - Farrington, Ken

PY - 1991

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N2 - We have described 4 patients with chronic renal failure receiving regular hacmodialysis treatment who underwent total parathyroidectomy with autotransplantalion of parathyroid fragments into the forearm musculature for hypercalcacmic hyperparathyroidism. In all. there was an immediate and profound fall in plasma calcium levels. Hypercalcaemia recurred 1-5 years post-operatively and was resistant to resection of the autograft. In 3 cases, lhallium-lechnetium subtraction scanning and multiple venous sampling for estimation of parathyroid hormone levels suggested multiple sites of hypersecretion of parathyroid hormone in the neck. In I case, these investigations revealed a mediastinal adenoma which was successfully removed. These cases reinforce previous suggestions that total parathyroidectomy is frequently incomplete and undermine the procedure of total parathyroidectomy with autotransplantation in patients with persisting uraemia.

AB - We have described 4 patients with chronic renal failure receiving regular hacmodialysis treatment who underwent total parathyroidectomy with autotransplantalion of parathyroid fragments into the forearm musculature for hypercalcacmic hyperparathyroidism. In all. there was an immediate and profound fall in plasma calcium levels. Hypercalcaemia recurred 1-5 years post-operatively and was resistant to resection of the autograft. In 3 cases, lhallium-lechnetium subtraction scanning and multiple venous sampling for estimation of parathyroid hormone levels suggested multiple sites of hypersecretion of parathyroid hormone in the neck. In I case, these investigations revealed a mediastinal adenoma which was successfully removed. These cases reinforce previous suggestions that total parathyroidectomy is frequently incomplete and undermine the procedure of total parathyroidectomy with autotransplantation in patients with persisting uraemia.

KW - Chronic renal failure

KW - Haemodialysis

KW - Hypercalcaemia

KW - Hyperparathyroidism

KW - Thallium-technetium subtraction scan

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ER -

Pitfalls after total parathyroidectomy and parathyroid allotransplantation in chronic renal failure

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