Chemical parathyroidectomy for recurrence of secondary hyperparathyroidism

A. Giangrande, A. Castiglioni, L. Solbiati, E. Ballarati, F. Caligara

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To avoid the risks of reoperation, we treated 15 uremic patients on regular extracorporeal dialysis and affected by hyperparathyroidism recurring after subtotal parathyroidectomy with ultrasound-guided ethanol injection. Follow-up was extended to 12 months after the last injection and for 11 patients to 24 months. Plasma parathyroid hormone concentration, as measured with a carboxyterminal parathyroid hormone (c-PTH) radioimmunoassay (normal, 0.2 to 2 ng/mL), significantly decreased from a basal value of 19.29 ± 14.73 ng/mL to 11.19 ± 9.54 ng/mL at 1 month, 7.45 ± 4.99 ng/mL at 6 months, 6.91 ± 4.71 ng/mL at 12 months, and 6.51 ± 3.89 ng/mL at 24 months. Total and bone alkaline phosphatase decreased in parallel. The only remarkable side effect was transient dysphonia, which occurred in two cases. These data suggest that the technique of ultrasound-guided fine-needle ethanol injection might be a valuable alternative to surgery for recurrent hyperparathyroidism after subtotal parathyroidectomy in selected patients. This should be confirmed in larger series of patients and with a more prolonged follow-up.

Original languageEnglish
Pages (from-to)421-426
Number of pages6
JournalAmerican Journal of Kidney Diseases
Issue number3
Publication statusPublished - 1994

ASJC Scopus subject areas

  • Nephrology


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