2021, Number 1
Tertiary Hyperparathyroidism as a Manifestation of Bone Mineral Metabolism Disease in Kidney Transplant Recipient: a Diagnostic and Therapeutic Challenge. Presentation of a Clinical Case
Language: Spanish
References: 10
Page: 72-78
PDF size: 393.02 Kb.
ABSTRACT
Tertiary hyperparathyroidism (THPT) is characterized by hypercalcemia and autonomous hyperparathyroidism in the context of persistent secondary hyperparathyroidism (SHPT). THPT is related with extraskeletal calcifications, calciphylaxis, fractures, bone pain, progressive loss of bone mineral density, nephrocalcinosis, lithiasis, kidney allograft dysfunction and rejection, neuropsychiatric alterations, cardiovascular disease, and high morbimortality. Subtotal parathyroidectomy is the gold standard for treatment, with high cure rates. We described a case of THPT as a manifestation of Bone Mineral Metabolism Disease after a successful kidney transplant, with an insidious evolution and severe bone damage, with an adequate response to subtotal parathyroidectomy. We evidenced that early diagnosis and treatment of THPT in kidney transplant recipients is essential to the diminution of comorbidities, the improvement of prognosis and the optimization of health resources.REFERENCES
Shindo M, Lee JA, Lubitz CC, McCoy KL, Orloff LA,Tufano RP, et al. The Changing Landscape of Primary,Secondary, and Tertiary Hyperparathyroidism:Highlights from the American College of SurgeonsPanel, “What’s New for the Surgeon Caringfor Patients with Hyperparathyroidism”. J AmColl Surg. 2016;222(6):1240-50. doi: 10.1016/j.jamcollsurg.2016.02.024.
Balcázar-Hernández L, Vargas-Ortega G, González-Virla B, Cruz-López M, Rodríguez-Gómez R,Espinoza-Pérez R, et al. Biochemical characteristicsof bone mineral metabolism before and throughoutthe first year after kidney transplantation, persistenthyperparathyroidism, and risk factors in a latinpopulation. Int J Endocrinol. 2020;2020:6913506. doi: 10.1155/2020/6913506.