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Autonomy of Parathyroid Function After Renal Homotransplantation
- Requests for reprints should be addressed to Major John J. McPhaul, Jr., MC, Chief, Renal Section, Wilford Hall USAF Hospital, Lackland Air Force Base, San Antonio, Tex.
Excerpt
Secondary hyperparathyroidism occurs commonly in chronically uremic patients (1-4). It has been felt to represent a physiologic adjustment to the hypocalcemia that results from impaired gastrointestinal absorption of calcium and renal phosphorus retention (5, 6). Although it appears to evolve as a compensating homeostatic mechanism, the hyperparathyroidism may lead to disabling symptomatology requiring vigorous medical or surgical therapy (5, 7-9). Indeed, the sequelae of the hyperparathyroid state may overshadow other symptoms of the uremia. It has been suggested that these hyperplastic parathyroid glands may lose their homeostatic role and that occasionally an autonomous state of hyperparathyroidism may develop (7, 10,
Summario in Interlingua
Cinque de 7 superviventes a longe termino in suuccessose homograffage renal human disveloppava evidentia de persistente hyperparathyroidismo durante le periodo de reconvalescentia. Isto esseva manifeste in sustenite o intermittente hypercalciemia, hypophosphatemia, excessive phosphaturia, e deprimite reabsorption tubular de phosphoro. Le observate hypercalciemia e altere stigmas in le presentia de adequate functiones renal esseva interpretate como evidentia de autonome o inappropriate hyperparathyroidismo. A causa del persistentia de iste condition in 3 patientes, parathyroidectomia subtotal esseva effectuate e provideva alleviamento del anormal datos biochimic. Le 2 altere patientes non esseva operate sed hyperplasia parathyroide esseva confirmate al necropsia in un de illes 8 menses post le homograffage renal. Evidentia de hyperparathyroidismo in le quinte patiente ha subsidite finalmente post 2 annos de observation sin mesuras corrective. Ben que nostre experientias suggestiona que secundari hyperparathyroidismo compensatori pote regreder spontaneemente, le persistente hypercalciemia in le patiente post-operatori pare reflecter autonomia parathyroide e require un intervention chirurgic.
Article and Author Information
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From the Departments of Medicine and Pathology, Wilford Hall USAF Hospital, Aerospace Medical Division (AFSC), Lackland Air Force Base, San Antonio, Tex.
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- Received June 23, 1966.
- Accepted June 29, 1966.
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