Recurrent tertiary hyperparathyroidism due to supernumerary parathyroid glands in a patient receiving long-term hemodialysis: a case report

doi:10.1186/s12902-019-0346-7

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Title:	Recurrent tertiary hyperparathyroidism due to supernumerary parathyroid glands in a patient receiving long-term hemodialysis: a case report
Authors:	Tai, Tsai-Sung Hsu, Yueh-Han Chang, Jia Ming Chien-Chin Chen(陳建欽)
Contributors:	Ditmanson Med Fdn, Chia Yi Christian Hosp, Dept Internal Med Ditmanson Med Fdn, Dept Med Res, Chia Yi Christian Hosp Min Hwei Jr Coll Hlth Care Management, Dept Nursing Ditmanson Med Fdn, Div Thorac Surg, Dept Surg, Chia Yi Christian Hosp Ditmanson Med Fdn, Dept Pathol, Chia Yi Christian Hosp Chia Nan Univ Pharm & Sci, Dept Cosmet Sci
Keywords:	Hemodialysis Supernumerary parathyroid glands Parathyroidectomy Tertiary hyperparathyroidism Hungry bone syndrome Case report
Date:	2019-01
Issue Date:	2020-07-29 13:51:20 (UTC+8)
Publisher:	BMC
Abstract:	Background: Renal hyperparathyroidism is a common complication of chronic kidney disease (CKD) or end-stage renal disease (ESRD) characterized by elevated parathyroid hormone levels secondary to derangements in the homeostasis of calcium, phosphate, and vitamin D. Rapid correction of severe and prolonged hyperparathyroidism by surgical parathyroidectomy in long-term hemodialysis patients occasionally causes hungry bone syndrome. These patients then exhibit severe and long-lasting secondary or tertiary hyperparathyroidism with high bone turnover. Case presentation: We report a case of recurrent tertiary hyperparathyroidism after total parathyroidectomy due to supernumerary parathyroid gland in a patient with long-term hemodialysis. Supplementation with intravenous calcium, oral calcium, and vitamin D immediately after patient surgery helps to prevent and treat hungry bone syndrome. Conclusions: We should prompt a search for the supernumerary parathyroid glands in ESRD patients, who have recurrent or persistent hyperparathyroidism after total parathyroidectomy. ESRD patients are more likely to develop hungry bone syndrome after parathyroidectomy. Prevention and treatment of hungry bone syndrome may be required after ectopic parathyroidectomy in clinical practice.
Relation:	Bmc Endocrine Disorders, v.19, 16
Appears in Collections:	[Dept. of Cosmetic Science and institute of cosmetic science] Periodical Articles

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