A Case Report: Total Parathyroidectomy with Autotransplantation for Secondary Hyperparathyroidism

Sung Hoon Kim; Da Hea Seo; Seun Deuk Hwang; Ji Won Kim

doi:10.11106/ijt.2019.12.1.54

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Kim, Seo, Hwang, and Kim: A Case Report: Total Parathyroidectomy with Autotransplantation for Secondary Hyperparathyroidism

Case Report

International Journal of Thyroidology 2019; 12(1): 54-57.

Published online: 31 May 2019

DOI: https://doi.org/10.11106/ijt.2019.12.1.54

A Case Report: Total Parathyroidectomy with Autotransplantation for Secondary Hyperparathyroidism

Sung Hoon Kim¹, Da Hea Seo², Seun Deuk Hwang³, Ji Won Kim¹

¹Department of Otolaryngology, Inha University College of Medicine, Incheon, Korea.

²Department of Endocrinology and Metabolism, Inha University College of Medicine, Incheon, Korea.

³Department of Nephrology and Hypertension, Inha University College of Medicine, Incheon, Korea.

Correspondence: Ji Won Kim, MD, Department of Otolaryngology, Inha University College of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea. Tel: 82-32-890-3028, Fax: 82-32-890-3580, hopefuljw@gmail.com

Received 4 April 2019 Revised 29 April 2019 Accepted 7 May 2019

The Korean Thyroid Association

(open-access):

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Secondary hyperparathyroidism (HPT) usually result from parathyroid gland hyperplasia that produces excess parathyroid hormone (PTH). Decreased renal function leads to elevate serum phosphate levels and reduce vitamin D production, which results in hypocalcemia. Skeletal resistance to PTH results in persistently and frequently extremely elevated PTH levels and renal osteopathy. Treatment of choice for secondary HPT is medical management including calcitriol and vitamin D. However, for some cases in calciphylaxis and the failure including PTH >800 pg/mL or osteoporosis under maximal medical management surgical intervention could be an alternative option. We described a case of 47-year-old woman with surgical intervention for secondary hyperparathyroidism.

Keywords: Secondary hyperparathyroidism, Parathyroidectomy, Autotransplantation

Figures and Tables

Fig. 1

Parathyroid SPECT/CT (single-photon emission computed tomography/computed tomography) findings represent multiple increased MIBI (methoxyisobutyl-isonitrile) uptake (A), right superior (B), left inferior portion of thyroid gland (C).

Fig. 2

Round-shaped hyperplastic left inferior parathyroid in left level VI - paratracheal area (A), resected mass (B).

Acknowledgments

This research was supported by Inha university research grant.

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