Parathyroidectomy for Refractory Secondary Hyperparathyroidism with Severe Bone Disease

Parathyroidectomy for Refractory Secondary Hyperparathyroidism with Severe Bone Disease

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Advances in the medical management of secondary hyperparathyroidism due to renal failure have decreased the use of parathyroidectomy as a treatment option.However, some patients with end-stage renal disease still progress to refractory hyperparathyroidism and debilitating Creator T-Shirt bone disease, for which parathyroidectomy may be warranted.We describe a case of a 35-year-old female on chronic hemodialysis who presented with bone pains, deformities, decrease in height and recurrent pathologic fractures.

She had markedly elevated parathyroid hormone (PTH), vitamin D deficiency, persistent hyperphosphatemia and hypocalcemia despite therapeutic measures.Subtotal parathyroidectomy was done with eventual improvement of biochemical abnormalities, resolution of bone pains and healing Dab Rigs of fractures.