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A case of post-transplant hyperparathyroidism treated with ethanol injection
- Source :
- Pediatric nephrology (Berlin, Germany). 17(4)
- Publication Year :
- 2002
-
Abstract
- A 15-year-old boy with chronic renal failure secondary to Alport's syndrome underwent living-related renal transplantation from his 48-year-old father. His primary immunosuppressive regimen was composed of tacrolimus, mizolibine, and methylprednisolone. The postoperative course was satisfactory with one episode of mild acute rejection, treated successfully with methylprednisolone pulse therapy. Two months later, hypercalcemia (11.8-13.2 mg/dl) and hypophosphatemia (2.5-3.0 mg/dl) were noted without any bone symptoms. The serum intact-parathyroid hormone (PTH) and serum alkaline phosphatase levels were 240 pg/ml and 2483 IU/l, respectively. Ultrasound studies revealed enlargement of the two parathyroid glands. Under the diagnosis of tertiary hyperparathyroidism, he underwent percutaneous ethanol injection (PEIT) into the left parathyroid gland. Although levels of serum calcium and phosphorus returned to normal ranges and the intact PTH level decreased to 95 pg/ml with the three injections, another injection was needed to normalize recurrent hypercalcemia 2 months later. The patient experienced only transient mild dysphonia and local pain after PEIT. Although PEIT is believed less effective than parathyroidectomy, it has some advantages such as applicability to high-risk patients, repeatability of treatment, low incidence and severity of side effects.
- Subjects :
- Parathyroidectomy
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Urology
Tertiary hyperparathyroidism
Administration, Cutaneous
Injections
Parathyroid Glands
medicine
Humans
Hyperparathyroidism
Ethanol
business.industry
medicine.disease
Kidney Transplantation
Surgery
Transplantation
medicine.anatomical_structure
Methylprednisolone
Nephrology
Pediatrics, Perinatology and Child Health
Parathyroid gland
Percutaneous ethanol injection
business
Hypophosphatemia
medicine.drug
Subjects
Details
- ISSN :
- 0931041X
- Volume :
- 17
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Pediatric nephrology (Berlin, Germany)
- Accession number :
- edsair.doi.dedup.....c38eb724971b42880bd813838b85ed32