Hypercalcemia resistant to cinacalcet caused by a mediastinal hyperplastic parathyroid gland in a renal transplant patient
- 01.08.2017
- case report
Erschienen in:
- Verfasst von
-
Manabu Okada, MD
Korrespondierender Autor Manabu Okada, MD
- Department of Transplant and Endocrine Surgery, Nagoya Daini Red Cross Hospital, 466-8650, Showa-ku, Japan
-
Kenta Futamura, MD
Kenta Futamura, MD
- Department of Transplant and Endocrine Surgery, Nagoya Daini Red Cross Hospital, 466-8650, Showa-ku, Japan
-
Takahisa Hiramitsu, MD, PhD
Takahisa Hiramitsu, MD, PhD
- Department of Transplant and Endocrine Surgery, Nagoya Daini Red Cross Hospital, 466-8650, Showa-ku, Japan
-
Makoto Tsujita, MD
Makoto Tsujita, MD
- Department of Transplant and Endocrine Surgery, Nagoya Daini Red Cross Hospital, 466-8650, Showa-ku, Japan
-
Norihiko Goto, MD, PhD
Norihiko Goto, MD, PhD
- Department of Transplant and Endocrine Surgery, Nagoya Daini Red Cross Hospital, 466-8650, Showa-ku, Japan
-
Shunji Narumi, MD, PhD
Shunji Narumi, MD, PhD
- Department of Transplant and Endocrine Surgery, Nagoya Daini Red Cross Hospital, 466-8650, Showa-ku, Japan
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Yoshihiko Watarai, MD, PhD
Yoshihiko Watarai, MD, PhD
- Department of Transplant and Endocrine Surgery, Nagoya Daini Red Cross Hospital, 466-8650, Showa-ku, Japan
-
Toshihiro Ichimori, MD
Toshihiro Ichimori, MD
- Department of Transplant and Endocrine Surgery, Nagoya Daini Red Cross Hospital, 466-8650, Showa-ku, Japan
-
Yoshihiro Tominaga, MD, PhD
Yoshihiro Tominaga, MD, PhD
- Department of Transplant and Endocrine Surgery, Nagoya Daini Red Cross Hospital, 466-8650, Showa-ku, Japan
- Erschienen in
- European Surgery | Ausgabe 4/2017
Summary
Background
Renal hyperparathyroidism is a common complication in patients with chronic kidney disease. Cinacalcet, a kind of calcimimetic, has been reported to be an effective and safe treatment option in renal transplant patients with hyperparathyroidism. However, some patients require parathyroidectomy due to resistance to cinacalcet treatment. It is uncertain when we should give up treatment with cinacalcet and perform parathyroidectomy for persistent hyperparathyroidism.
Case report
We experience the first documented case in which cinacalcet-resistant hypercalcemia was caused by a mediastinal hyperplastic parathyroid gland after renal transplantation. The patient received total parathyroidectomy with autograft 4 years before renal transplantation. The levels of serum calcium and parathyroid hormone were controlled well with 25 mg daily of cinacalcet. Despite continuous treatment with cinacalcet, the patient developed hypercalcemia, hypercalciuria and nephrocarcinosis after renal transplantation. A mediastinal parathyroid lesion was revealed by imaging. Eventually, parathyroidectomy was performed for the mediastinal gland for the purpose of preventing new stone formation in the renal graft.
Conclusion
It was suggested that prompt parathyroidectomy is preferable rather than prolonged medical treatment for hypercalcemia resistant to cinacalcet caused by persistent hyperparathyroidism after renal transplantation. Furthermore, we should be extremely careful about hypercalcinuria and nephrocalcinosis when we prescribe cinacalcet for patients under hypercalcemia.
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- Titel
- Hypercalcemia resistant to cinacalcet caused by a mediastinal hyperplastic parathyroid gland in a renal transplant patient
- Verfasst von
-
Manabu Okada, MD
Kenta Futamura, MD
Takahisa Hiramitsu, MD, PhD
Makoto Tsujita, MD
Norihiko Goto, MD, PhD
Shunji Narumi, MD, PhD
Yoshihiko Watarai, MD, PhD
Toshihiro Ichimori, MD
Yoshihiro Tominaga, MD, PhD
- Publikationsdatum
- 01.08.2017
- Verlag
- Springer Vienna
- Erschienen in
-
European Surgery / Ausgabe 4/2017
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016 - DOI
- https://doi.org/10.1007/s10353-017-0484-y
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